| NPI | 1154764934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY WHITE Executive Director 315-801-4429 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: NY 3203003H) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2023-07-12 |