| NPI | 1043757404 |
|---|---|
| Doing Business As | CENTRACARE KIDNEY PROGRAM - SOUTH ST CLOUD |
| Entity Type | Organization |
| Authorized Contact | GREGORY R KLUGHERZ Vice President And CFO 320-255-5665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |