| NPI | 1467966127 |
|---|---|
| Doing Business As | HERITAGE LAKE DIALYSIS |
| Entity Type | Organization |
| Authorized Contact | SAMUEL WEY Sr Director Licensure&Certification 615-341-6641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2023-09-11 |