| NPI | 1891301370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAKEISHA ZEIGLER Authorized Agent 754-207-5634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2020-09-19 |
| Last Update Date | 2021-03-04 |