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Organization

RAI CARE CENTERS OF MICHIGAN I, LLC

Active
Other names
RAI-South East-Jackson
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JON M SUNDOCK (VICE PRESIDENT)
(615) 507-3307
Entity
Organization

Contact information

Practice address
200 SOUTH EAST AVE., JACKSON, MI 49201-2414
(517) 788-8727
(517) 788-4541
Mailing address
1550 W. MCEWEN DRIVE, SUITE 500, FRANKLIN, TN 37067-2311
(615) 661-1100
(615) 507-3300

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
01
08935
BCBS
MI
01
09448
BCBS
MI
05
404836079
MI
Enumeration date
10/03/2006
Last updated
02/15/2011
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