| NPI | 1235667130 | 
|---|---|
| Doing Business As | LAUREL LAKES DIALYSIS | 
| Entity Type | Organization | 
| Authorized Contact | SAMUEL T WEY VP, Licensure & Certification 615-341-6641 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | 
| Enumeration Date | 2017-05-23 | 
| Last Update Date | 2025-04-02 |