Organization
BRADEN RIVER REHABILITATION CENTER, LLC
Active
Parent organization
SOVEREIGN HEALTHCARE HOLDINGS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOVEREIGN HEALTHCARE HOLDINGS, LLC
Authorized official
MR. R. MARK CRONQUIST (MANAGER)
(404) 574-2100
Entity
Organization
Contact information
Practice address
2010 MANATEE AVE E, BRADENTON, FL 34208-1560
(941) 747-3706
(941) 746-7785
Mailing address
5887 GLENRIDGE DR NE, SUITE 150, ATLANTA, GA 30328-5574
(404) 574-2100
(404) 574-2105
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF15320961
FL
314000000X
Skilled Nursing Facility
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007332400
—
FL
Enumeration date
10/22/2012
Last updated
09/29/2014
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