Organization
SUNBRIDGE HEALTHCARE LLC
Active
Other names
Merry Wood Lodge
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
280 MT HEBRON RD, ELMORE, AL 36025-1526
(334) 567-8484
Mailing address
280 MT HEBRON RD, ELMORE, AL 36025-1526
(334) 567-8484
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
16967
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010-693
BCBS OF ALABAMA, PO BOC 9
AL
05
—
4750190S
—
AL
Enumeration date
05/11/2006
Last updated
08/17/2018
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