Jicarilla Apache Nation
Jicarilla Apache Nation provides End-Stage Renal Disease (ESRD) Treatment Clinic/Center services in Dulce, New Mexico. Registered with an NPI since 2013.
- In the registry since
- 2013
Practice location Address checks out
450 N Mundo DrDulce, NM 87528 Not confirmed with CMS for 11 years — call before visiting
Phone: (575) 759-4206
Fax: (575) 759-4471
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center (primary) | Taxonomy 261QE0700X |
|---|
Record details
| NPI number | 1881020089 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Ty Vicenti — President · (575) 759-4201 |
| Other names | Jicarilla Apache Nation Dialysis Treatment Center |
| NPI enumerated | September 19, 2013 |
| Last updated in NPPES | May 20, 2015 |
| Mailing address | 450 N Mundo Dr., Dulce, NM 87528 |
Clinicians affiliated with this facility
- Tudor Ocneanu, MD Nephrology Physician · Santa Fe, NM