NPI | 1104231554 |
---|---|
Entity Type | Organization |
Authorized Contact | MORUFU ALAUSA Medical Director/CEO 815-741-6830 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment |
Enumeration Date | 2014-06-24 |
Last Update Date | 2018-10-01 |