Organization
LINCOLN PARK KIDNEY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
1491 SOUTHFIELD RD, LINCOLN PARK, MI 48146-2320
(313) 928-4560
(313) 928-4620
Mailing address
1491 SOUTHFIELD RD, LINCOLN PARK, MI 48146-2320
(313) 928-4560
(313) 928-4620
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/11/2017
Last updated
01/14/2023
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