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Organization

HARBORSIDE OF DAYTON LIMITED PARTNERSHIP

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

Provider details

NPI number
Legal business name
SUNBRIDGE HEALTHCARE LLC
Authorized official
THOMAS DIVITTORIO (PRESIDENT DIRECTOR)
(505) 821-3355
Entity
Organization

Contact information

Practice address
323 FOREST AVE, DAYTON, OH 45405-4599
(937) 224-0793
(937) 224-0799
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
5318
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2083776
OH
Enumeration date
08/22/2006
Last updated
06/12/2014
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