Facility Name * Facility Phone * Facility Fax Facility Open Date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 Medical Director Ownership * - Select -DavitaFMCDCIIndependent Address Street Address * City * State * - Select -MichiganMinnesotaNorth DakotaSouth DakotaWisconsin Zip * Different mailing address? Yes No Mailing Address Street Address City State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Location Type * Free-standing Hospital-based Satellite unit Number of Dialysis Stations Number of Isolation Stations Number of Training Rooms Services Offered * In-Center Hemodialysis Home Hemodialysis Home Training (HD) Home Training (PD) Home Support (HD) Home Support (PD) Peritoneal Dialysis Transplantation Accepts Pediatrics Accepts Transients CCPD CAPD Frequent In-Center Dialysis Frequent Home Dialysis Home IPD In-Center PD Nocturnal Hemodialysis Dialyzer Reuse Shift After 5 PM Number of M-W-F Shifts Number of T-Th-S Shifts M-W-F Open Hour Hour123456789101112 : Minute Minute0030 am pm M-W-F Close Hour Hour123456789101112 : Minute Minute0030 am pm T-Th-S Open Hour Hour123456789101112 : Minute Minute0030 am pm T-Th-S Close Hour Hour123456789101112 : Minute Minute0030 am pm Facility Contact * Facility Contact Email * Facility Contact Phone *