| NPI | 1720079387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN M JACOBS Accounts Receivable Manager 208-367-3076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: ID BM5584708) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2020-08-22 |