| NPI | 1881766749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANAGED CARE Manager, Provider Enrollment 404-785-7876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2025-02-04 |