| NPI | 1902918790 |
|---|---|
| Doing Business As | RCG LAKE VILLAGE |
| Entity Type | Organization |
| Authorized Contact | NED O KRONFOL Owner 662-335-4105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-04-24 |