Organization
LIBERTY AT HOME DIALYSIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SANTELLI (MEMBER)
(206) 236-5001
Entity
Organization
Contact information
Practice address
5535 RED BIRD CENTER DR, SUITE 150, DALLAS, TX 75237-1921
(214) 331-1112
(214) 331-1115
Mailing address
5535 RED BIRD CENTER DR, SUITE 150, DALLAS, TX 75237-1921
(214) 331-1112
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
017487
TX
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
TX
Other
Enumeration date
05/28/2015
Last updated
08/18/2016
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