Organization
1240 PINEBROOK ROAD LLC
Active
Parent organization
SUNBRIDGE HEALTHCARE CORPORATION
Other names
Pinebrook 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
1240 PINEBROOK RD, VENICE, FL 34285-6421
(941) 488-6733
(941) 484-7924
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
SNF 14390962
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025266200
—
FL
Enumeration date
07/26/2006
Last updated
10/01/2009
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