Provider Demographics
NPI:1700658440
Name:KIDNEY TRAIN LLC.
Entity Type:Organization
Organization Name:KIDNEY TRAIN LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VIRYDIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:760-586-6103
Mailing Address - Street 1:26355 CARNEGIE AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-6459
Mailing Address - Country:US
Mailing Address - Phone:619-494-2474
Mailing Address - Fax:
Practice Address - Street 1:26355 CARNEGIE AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-6459
Practice Address - Country:US
Practice Address - Phone:619-494-2474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysisGroup - Multi-Specialty