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Organization

DVA RENAL HEALTHCARE INC

Active
Other names
Hi-Desert Dialysis
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL T. WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization

Contact information

Practice address
56845 29 PALMS HWY, YUCCA VALLEY, CA 92284-2940
(760) 365-8706
(760) 228-0154
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
240000630
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1265406045
CA
Enumeration date
02/16/2006
Last updated
08/20/2025
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