| NPI | 1568037349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONAVENTURA ROSE CELESTINE Administrator 346-307-7767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2021-05-24 |