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Organization

SUNBRIDGE HEALTHCARE LLC

Active
Other names
River Ridge Care and Rehabilitation Center
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM A. MATHIES (PRESIDENT DIRECTOR)
(505) 821-3355
Entity
Organization

Contact information

Practice address
640 FILER AVE W, TWIN FALLS, ID 83301-4533
(208) 734-8645
(208) 734-4645
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
311500000X
Alzheimer Center (Dementia Center)
32
ID
314000000X
Skilled Nursing Facility
Primary
32
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010013057
BLUE SHIELD OF IDAHO
ID
05
0029215
ID
01
01305
BLUE CROSS OF IDAHO
ID
01
8750370802
AMERICAN PIONEER
ID
Enumeration date
05/26/2006
Last updated
01/08/2013
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