| NPI | 1578138517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY SMITH Director 302-290-7408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2025-01-02 |