Organization
PEAK MEDICAL PEACHTREE, INC.
Active
Parent organization
SUNBRIDGE HEALTHCARE CORPORATION
Other names
Country Lane Assisted Living
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
985 S 800 W, BRIGHAM CITY, UT 84302-3042
(435) 723-1394
(435) 723-1416
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
310400000X
Assisted Living Facility
2004ALI47536
UT
310400000X
Assisted Living Facility
Primary
2004ALII7538
UT
Other
Enumeration date
05/24/2006
Last updated
09/28/2009
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