OrganizationActive
Life- Alysis Kidney Center, LLC
NPI 1255442190 · Health Maintenance Organization · Detroit, MI
Provider details
- NPI number
- 1255442190
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Lyle Gray, Partner(313) 371-5433
- License
- 302R00000X (MI)
Specialties & taxonomies
Managed Care Organizations
Practice location
5830 Conner St
Detroit, MI 48213-3458
Phone: (313) 371-5433
Fax: (313) 371-6937
Approximate (ZIP-level) locationGet directions
Mailing address
5830 Conner St
Detroit, MI 48213-3458
Registry dates
- Enumerated
- 2006-08-31
- Last updated
- 2013-01-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.