| NPI | 1346209590 |
|---|---|
| Doing Business As | LAKE VILLA DIALYSIS |
| Entity Type | Organization |
| Authorized Contact | JOHN WINSTEL Chief Accounting Officer 253-733-4501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2022-10-10 |