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General NPI Number Information
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NPI Number | 1609701275
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Entity Type | Organization
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Legal Business Name | DIALYSIS ACCESS CARE OF SOUTHEAST MICHIGAN, LLC
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Dates
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Enumeration Date | 06/16/2026
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Last Update Date | 06/16/2026
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Provider Practice Location Address
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Address Line | 2890 WASHTENAW RD
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City | YPSILANTI
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State | MI
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Zip | 48197-1507
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Country | US
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Telephone | 734-528-9433
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Fax | 734-582-9455
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Provider Business Mailing Address
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Address Line | 5333 MCAULEY DR RM 4003
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City | YPSILANTI
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State | MI
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Zip | 48197-1099
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Country | US
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Telephone | 734-715-1706
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Fax | 734-863-3602
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | TABETHA THOMPSON
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Credential |
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Telephone | 734-715-1706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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