| NPI | 1083318760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHONTA WILLIAMS COO 346-388-0656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies | |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2023-07-10 |