LASSEN DIALYSIS, LLC (NPI# 1619386489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619386489 |
| Entity Type | Organization |
| Organization Name | LASSEN DIALYSIS, LLC |
| Other Organization Name | DEARBORN HOME DIALYSIS |
| Practice Address |
22030 Park St Dearborn MI 48124-2854 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 3137927343 |
| Practice Fax Number | 3137928341 |
| Mailing Telephone | 6153204514 |
| Mailing Fax Number | 8665949961 |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2019-01-28 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFC & TREASURER) |
| Authorized Official Telephone | 2537334500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1619686489 | 05 |
| Other Name | Type Code |
|---|---|
| Dearborn Home Dialysis | Doing Business As Name - Organization |
| Street Address |
22030 PARK ST |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-2854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669473880 | Zafer Husami | Internal Medicine | 22030 Park St, Ste 103, Dearborn, MI 48124-2854 | 2005-08-10 |
| 1689833956 | Dva Healthcare Renal Care Inc | Clinic/Center | 22030 Park St, Dearborn, MI 48124-2854 | 2008-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568482958 | Henry Ford Health System | Clinic/Center | 19001 Hubbard Dr, Dearborn, MI 48126-2637 | 2006-07-20 |
| 1114962925 | East Dearborn Dialysis LLC | Clinic/Center | 13200 W Warren Ave, Dearborn, MI 48126-1415 | 2006-06-17 |
| 1962463463 | Dva Healthcare Renal Care Inc | Clinic/Center | 1185 Monroe St, Dearborn, MI 48124-2814 | 2006-04-01 |
| 1699275487 | Bio Medical Applications of Michigan Inc | Clinic/Center | 5250 Auto Club Dr, Dearborn, MI 48126-2619 | 2018-02-19 |
| 1801215959 | Lassen Dialysis LLC | Clinic/Center | 18100 Oakwood Blvd, Ste 206, Dearborn, MI 48124-4085 | 2014-04-15 |
| 1356783724 | Dearborn Kidney Center LLC | Clinic/Center | 5111 Auto Club Dr, Suite 120, Dearborn, MI 48126-2684 | 2013-07-25 |
| 1164743845 | Renal Treatment Centers Illinois Inc | Clinic/Center | 13200 W Warren Ave, Dearborn, MI 48126-2410 | 2010-06-17 |
| 1821310806 | Oakwood Healthcare Inc | Clinic/Center | 18100 Oakwood Blvd, Suite 206, Dearborn, MI 48124-4085 | 2010-02-18 |
| 1689833956 | Dva Healthcare Renal Care Inc | Clinic/Center | 22030 Park St, Dearborn, MI 48124-2854 | 2008-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497961 | Saint Marina Home Dialysis LLC | Clinic/Center | 26711 Northwestern Hwy Ste 125, Southfield, MI 48033-2170 | 2020-11-05 |
| 1144820226 | Heritage Home Dialysis LLC | Clinic/Center | 1580 N Leroy St Ste 6, Fenton, MI 48430-2801 | 2020-10-28 |
| 1386262350 | Delta Renal Care Pllc | Clinic/Center | 3981 Elizabeth Ave, Canton, MI 48188-7223 | 2020-07-07 |
| 1457973257 | Fms Owosso, LLC | Clinic/Center | 918 Corunna Ave, Owosso, MI 48867-3768 | 2020-05-14 |
| 1023650926 | Falmont Dialysis LLC | Clinic/Center | 37290 5 Mile Rd, Livonia, MI 48154-1848 | 2019-10-11 |
| 1487112942 | Michigan Dialysis Services, LLC | Clinic/Center | 275 N Canton Center Rd, Canton, MI 48187 | 2019-03-04 |
| 1487123600 | Concerto Michigan LLC | Clinic/Center | 14700 Farmington Rd Ste 108, Livonia, MI 48154-5462 | 2018-11-16 |
| 1245715291 | Brooksprings Dialysis, LLC | Clinic/Center | 2391 Fifteen Mile Rd, Sterling Heights, MI 48310 | 2018-09-26 |
| 1851886592 | Fms Rochester Hills, LLC | Clinic/Center | 26400 W 12 Mile Rd Ste 112, Southfield, MI 48034-1785 | 2018-06-26 |
| 1801399753 | Kasaskia Dialysis LLC | Clinic/Center | 18001 E 10 Mile Rd Ste B, Roseville, MI 48066-3803 | 2018-03-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.