| NPI | 1881766749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUETTA CODY Manager, Provider Enrollment 404-785-7876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: GA 044-079) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2024-03-04 |