| NPI | 1588200398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY WOODS Administrator 754-224-0383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2019-11-27 |
| Last Update Date | 2019-11-27 |