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Organization

4602 NORTHGATE COURT LLC

Active
Parent organization
SUNBRIDGE HEALTHCARE LLC
Other names
Springwood Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
SUNBRIDGE HEALTHCARE LLC
Authorized official
MICHAEL T BERG (ASSISTANT SECRETARY)
(505) 468-4742
Entity
Organization

Contact information

Practice address
4602 NORTHGATE CT, SARASOTA, FL 34234-2125
(941) 355-2913
(941) 355-4259
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 15130962
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
025301400
FL
Enumeration date
07/26/2006
Last updated
02/09/2016
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