Organization
LASSEN DIALYSIS LLC
Active
Other names
Riverview 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
18236 FORT ST, RIVERVIEW, MI 48193-7439
(734) 283-4513
(734) 283-4570
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, 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
—
1497010474
—
MI
Enumeration date
07/06/2012
Last updated
01/10/2025
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