# HBR BARDWELL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SUNBRIDGE HEALTHCARE CORPORATION
- **Other names:** Countryside Care and Rehabilitation Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1851402093
- **Legal business name:** SUNBRIDGE HEALTHCARE CORPORATION
- **Authorized official:** WILLIAM A MATHIES (PRESIDENT DIRECTOR)
- **Authorized official phone:** (505) 821-3355

## Contact information

- **Practice address:** 47 MARGO AVE, BARDWELL, KY 42023-9005
- **Practice address phone:** (270) 628-5424
- **Practice address fax:** (270) 628-0311
- **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 | — | KY | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 09/30/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 12505244 | — | KY |