Organization
KIDNEY CENTER OF BEAR CREEK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
11058 W JEWELL AVE, LAKEWOOD, CO 80232-6139
(303) 233-4204
(303) 233-4214
Mailing address
11058 W JEWELL AVE, LAKEWOOD, CO 80232-6139
(303) 233-4204
(303) 233-4214
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70579563
—
CO
Enumeration date
09/17/2010
Last updated
01/13/2023
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