Organization
TAOS HOME DIALYSIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOLYN WILLIAMS (ADMINISTRATOR)
(505) 575-9996
Entity
Organization
Contact information
Practice address
1415 WEIMER RD, TAOS, NM 87571-6383
(505) 670-3669
(505) 212-2992
Mailing address
PO BOX 22566, SANTA FE, NM 87502-2566
(575) 999-6100
(575) 999-6440
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
01/26/2021
Last updated
01/13/2023
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