| NPI | 1891712766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAINDEL BELIZAIRE Physician Medical Director 770-994-0171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: GA 112780) |
| Additional Taxonomies | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: GA 052252) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2008-07-13 |