# SUNBRIDGE BRASWELL ENTERPRISES LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** REGENCY HEALTH SERVICES LLC
- **Other names:** Laurel Park Behavioral Health Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639126782
- **Legal business name:** REGENCY HEALTH SERVICES LLC
- **Authorized official:** MICHAEL T. BERG (ASSISTANT SECRETARY)
- **Authorized official phone:** (505) 468-4742

## Contact information

- **Practice address:** 1425 LAUREL AVE, POMONA, CA 91768-2837
- **Practice address phone:** (909) 622-1069
- **Practice address fax:** (909) 622-4319
- **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 | 950000064 | CA | Yes |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 01/14/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT18548G | — | CA |