| NPI | 1033956479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL LATTA Dialysis Technician 313-932-0925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2024-07-12 |