| NPI | 1124893615 |
|---|---|
| Doing Business As | INNOVATIVE RENAL CARE JACKSON DIALYSIS CENTER |
| Entity Type | Organization |
| Authorized Contact | SARA ANNE BRADY Authorized Official 208-371-7878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2024-01-23 |