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Organization

SUNBRIDGE GARDENDALE HEALTH CARE CENTER, LLC

Active
Other names
Magnolia Ridge
Organization subpart
No

Provider details

NPI number
Authorized official
MICAHEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization

Contact information

Practice address
420 DEAN DR, GARDENDALE, AL 35071-2763
(205) 631-8709
(205) 608-1639
Mailing address
420 DEAN DR, GARDENDALE, AL 35071-2763
(205) 631-8709
(205) 608-1639

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
16266
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010-38
BCBS OF ALABAMA
AL
05
4754730S
AL
Enumeration date
05/11/2006
Last updated
03/30/2017
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