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CHALLIS DIALYSIS, LLC - Florida Company Profile

Company Details

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

National Provider Identifier

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

Contacts

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

Key Officers & Management

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 -

Fictitious Names

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

Events

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 -

Documents

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