Organization
KIDNEY CENTER OF LAFAYETTE LLC
Active
Other names
Kidney Center of Lafayette
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
2655 CRESCENT DRIVE, SUITE C, LAFAYETTE, CO 80026-3373
(720) 890-4661
(720) 890-4662
Mailing address
2655 CRESCENT DRIVE, SUITE C, LAFAYETTE, CO 80026-3373
(720) 890-4661
(720) 890-4662
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
—
24657859
—
CO
Enumeration date
10/23/2007
Last updated
01/10/2023
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