Provider Demographics
NPI:1932491669
Name:TAOS SENIOR LIVING PARTNERS LP
Entity Type:Organization
Organization Name:TAOS SENIOR LIVING PARTNERS LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-345-0700
Mailing Address - Street 1:414 CAMINO DE LA PLACITA
Mailing Address - Street 2:OFC 24
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6191
Mailing Address - Country:US
Mailing Address - Phone:575-758-8248
Mailing Address - Fax:
Practice Address - Street 1:414 CAMINO DE LA PLACITA
Practice Address - Street 2:OFC 24
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6194
Practice Address - Country:US
Practice Address - Phone:575-758-8248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1082314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility