Provider Demographics
NPI:1982212981
Name:COLLABORATIVE KIDNEY CARE LLC
Entity Type:Organization
Organization Name:COLLABORATIVE KIDNEY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:DCN, MS, RDN, LDN
Authorized Official - Phone:774-263-3523
Mailing Address - Street 1:76 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:ACUSHNET
Mailing Address - State:MA
Mailing Address - Zip Code:02743-1109
Mailing Address - Country:US
Mailing Address - Phone:774-263-3523
Mailing Address - Fax:
Practice Address - Street 1:76 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:ACUSHNET
Practice Address - State:MA
Practice Address - Zip Code:02743-1109
Practice Address - Country:US
Practice Address - Phone:774-263-3523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Multi-Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Multi-Specialty
No133VN1101XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, GerontologicalGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or WelfareGroup - Multi-Specialty