Organization
LAKE GRAY DIALYSIS CENTER LLC
Active
Other names
ARA COLLINS ROAD DIALYSIS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
6196 LAKE GRAY BLVD, SUITE 112, JACKSONVILLE, FL 32244-7503
(904) 772-0933
(904) 772-0934
Mailing address
6196 LAKE GRAY BLVD, SUITE 112, JACKSONVILLE, FL 32244-7503
(904) 772-0933
(904) 772-0934
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
07/22/2016
Last updated
01/10/2023
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