| NPI | 1720782410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHONTA WILLIAMS COO 346-388-0656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2023-07-10 |