Organization
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Active
Other names
Laurel Manor Dialysis Center at The Villages
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1950 LAUREL MANOR DR STE 190, THE VILLAGES, FL 32162-5608
(352) 259-0250
(352) 259-0335
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891988700
—
FL
Enumeration date
07/06/2006
Last updated
09/25/2024
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