| Organization Name: | HOME DIALYSIS SERVICES FRANKLIN MOUNTAINS LLC |
| NPI Number: | 1336594084 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MORUFU ALAUSA (MEDICAL DIRECTOR) |
| Mailing Address: | 880 Anthony Dr Suite 3a Anthony |
| State: | NM US |
| Postal Code: | 880219346 |
| Phone Number: | 8157416830 |
| Fax Number: | 8157416832 |
| NPI Enumeration Date: | 05/02/2016 |
| NPI Last Update Date: | 05/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |