# HP SUNNYBROOK OF TEXAS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sunnybrook Health Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114950300
- **Authorized official:** DOUGLAS K MITTLEIDER (PRESIDENT)
- **Authorized official phone:** (770) 619-0866

## Contact information

- **Practice address:** 3050 SUNNYBROOK DRIVE, CORPUS CHRISTI, TX 78415-1797
- **Practice address phone:** (361) 853-9981
- **Practice address fax:** (361) 853-1907
- **Mailing address:** 925 N POINT PKWY, SUITE 440, ALPHARETTA, GA 30005-5210
- **Mailing address phone:** (770) 619-0866
- **Mailing address fax:** (770) 870-2892

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 113261 | TX | Yes |
| 332BN1400X | Nursing Facility Supplies (DME) | 651 | GA | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | 651 | GA | — |

## Other

- **Enumeration date:** 07/09/2006
- **Last updated:** 11/12/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4245 | — | TX |