# SUNBRIDGE HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Ridge Solana Alzheimer's Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568402295
- **Authorized official:** MICHAEL BERG (ASSISTANT SECRETARY)
- **Authorized official phone:** (505) 821-3355

## Contact information

- **Practice address:** 817 E PLUM ST, MOSES LAKE, WA 98837-1870
- **Practice address phone:** (509) 765-7835
- **Practice address fax:** (509) 765-6705
- **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 |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | NH1152 | WA | — |
| 314000000X | Skilled Nursing Facility | NH1152 | WA | Yes |

## Other

- **Enumeration date:** 06/08/2006
- **Last updated:** 07/13/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4114435 | — | WA |
| 01 | — | 583 | MSC/PREMERA BLUE CROSS | WA |