Entity Name: | CHALLIS DIALYSIS, LLC |
Jurisdiction: | FLORIDA |
Filing Type: | Foreign Limited Liability Co. |
Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
Date Filed: | 27 Jun 2017 (8 years ago) |
Document Number: | M17000005438 |
FEI/EIN Number |
82-2007334
Federal Employer Identification (FEI) Number assigned by the IRS. |
Mail Address: | 601 Hawaii Street, El Segundo, CA, 90245, US |
Address: | 2000 16th Street, Denver, CO, 80202, US |
Place of Formation: | DELAWARE |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1700398427 | 2017-11-03 | 2023-10-24 | 5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN, 370277569, US | 10725 WILES RD, CORAL SPRINGS, FL, 330762014, US | |||||||||||||||||||||||||||
|
Phone | +1 615-320-4593 |
Fax | 8002935872 |
Phone | +1 954-796-9925 |
Fax | 9547967360 |
Authorized person
Name | SAMUEL T WEY |
Role | VP, LICENSURE & CERTIFICATION |
Phone | 6153416641 |
Taxonomy
Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
State | FL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 101433300 |
State | FL |
Name | Role | Address |
---|---|---|
TOTAL RENAL CARE, INC. | Auth | - |
CORAL SPRINGS RENAL VENTURES LLC | Auth | - |
Caldwell Samantha A | Auth | 2000 16th Street, Denver, CO, 80202 |
CORPORATION SERVICE COMPANY | Agent | - |
Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
---|---|---|---|---|---|---|
G25000026333 | BROOKSIDE DIALYSIS | ACTIVE | 2025-02-21 | 2030-12-31 | - | 10725 WILES RD, ATTN: JLD/SECGOVFIN., CORAL SPRINGS, FL, 33076 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF PRINCIPAL ADDRESS | 2023-04-14 | 2000 16th Street, JLD/SecGovFin, Denver, CO 80202 | - |
CHANGE OF MAILING ADDRESS | 2023-04-14 | 2000 16th Street, JLD/SecGovFin, Denver, CO 80202 | - |
Name | Date |
---|---|
ANNUAL REPORT | 2024-04-19 |
ANNUAL REPORT | 2023-04-14 |
ANNUAL REPORT | 2022-04-19 |
ANNUAL REPORT | 2021-04-20 |
ANNUAL REPORT | 2020-04-20 |
ANNUAL REPORT | 2019-04-15 |
ANNUAL REPORT | 2018-04-16 |
Foreign Limited | 2017-06-27 |
Date of last update: 03 Mar 2025
Sources: Florida Department of State