NPI | 1720095417 |
---|---|
Doing Business As | DIALYSIS CARE CENTER GREAT LAKES EAST |
Entity Type | Organization |
Authorized Contact | MORUFU OLATUNJI ALAUSA Authorized Official / Cmo 815-741-6830 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: MI 4301072901) |
Enumeration Date | 2006-08-02 |
Last Update Date | 2025-04-07 |