# SUNRISE HEALTHCARE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SunBridge Care & Rehab Hillside
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386691889
- **Authorized official:** WILLIAM A MATHIES (PRESIDENT DIRECTOR)
- **Authorized official phone:** (505) 821-3355

## Contact information

- **Practice address:** 3641 MEMORIAL BLVD, KINGSPORT, TN 37664-3422
- **Practice address phone:** (423) 246-2411
- **Practice address fax:** (423) 246-8997
- **Mailing address:** 101 SUN AVE NE, COMPLIANCE DEPARTMENT, ALBUQUERQUE, NM 87109-4373
- **Mailing address phone:** (505) 468-5604
- **Mailing address fax:** (505) 468-4681

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 0000000264 | TN | Yes |

## Other

- **Enumeration date:** 05/28/2006
- **Last updated:** 07/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0445295 | — | TN |
| 01 | — | 330690226 | JOHN DEERE | — |
| 01 | — | 62647 | BLUE CROSS/BLUE SHIELD OF | TN |
| 05 | — | 7440436 | — | TN |