Organization
SUNBRIDGE RETIREMENT CARE ASSOCIATES LLC
Active
Parent organization
SUNBRIDGE HEALTHCARE CORPORATION
Other names
Poplar Heights Care and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUNBRIDGE HEALTHCARE CORPORATION
Authorized official
WILLIAM A MATHIES (PRESIDENT DIRECTOR)
(505) 821-3355
Entity
Organization
Contact information
Practice address
804 S POPLAR ST, ELIZABETHTOWN, NC 28337-9226
(910) 862-8100
(910) 862-5386
Mailing address
101 SUN AVE NE, COMPLIANCE DEPARTMENT, ALBUQUERQUE, NM 87109-4373
(505) 468-5604
(505) 468-4681
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0420
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0088K
BCBS
NC
01
—
17968
PARTNERS
NC
05
—
3415267
—
NC
05
—
3416389
—
NC
01
—
345267
MEDCOST/MULTIPLAN
—
01
—
71-08310
UNITED HEALTHCARE
—
05
—
7803906
—
NC
Enumeration date
05/20/2006
Last updated
09/29/2009
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