| NPI | 1356362586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA LOLLO President 314-996-8401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: MO 324-26) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2021-03-16 |