GREAT LAKES DIALYSIS, L.L.C. is an end-stage renal disease (esrd) treatment clinic center in Detroit, MI. GREAT LAKES DIALYSIS, L.L.C. NPI is 1720095417. The provider is registered as an organization entity type.
The provider's business location address is:
14614 KERCHEVAL ST
DETROIT, MI
ZIP 48215-814
Phone: (313) 924-9670
Fax: (313) 924-9673
The provider's authorized official is Boniface Atakekor Tubie .
The authorized official title is President/ Ceo and has the following contact phone number (313) 924-9670.
The CLIA number assigned to this NPI record is 23D1011980 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 8/2/2006 and was last updated on 8/22/2020.