Organization
CRESTVIEW NURSING, LLC
Active
Parent organization
SUNBRIDGE HEALTHCARE CORPORATION
Other names
Crestview Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUNBRIDGE HEALTHCARE CORPORATION
Authorized official
MICHAEL BERG (ASSISTANT SECRETARY)
(505) 468-4742
Entity
Organization
Contact information
Practice address
1871 MIDLAND TRL, SHELBYVILLE, KY 40065-9111
(502) 589-3573
(502) 633-7890
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
100383
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12504890
—
KY
Enumeration date
08/17/2006
Last updated
09/19/2019
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