Provider Demographics
NPI:1023041456
Name:ARA-SEBRING DIALYSIS LLC
Entity Type:Organization
Organization Name:ARA-SEBRING DIALYSIS LLC
Other - Org Name:HIGHLANDS DIALYSIS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-371-7878
Mailing Address - Street 1:4245 SUN N LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2158
Mailing Address - Country:US
Mailing Address - Phone:863-382-9443
Mailing Address - Fax:863-382-9242
Practice Address - Street 1:4245 SUN N LAKE BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2158
Practice Address - Country:US
Practice Address - Phone:863-382-9443
Practice Address - Fax:863-382-9242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL892649200Medicaid
FL892649200Medicaid