Organization
SUNBRIDGE CLIPPER HOME OF WOLFEBORO LLC
Active
Parent organization
SUNBRIDGE HEALTHCARE LLC
Other names
Wolfeboro Bay Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUNBRIDGE HEALTHCARE LLC
Authorized official
MICHAEL BERG (ASSISTANT SECRETARY)
(505) 468-4742
Entity
Organization
Contact information
Practice address
39 CLIPPER DR, WOLFEBORO, NH 03894-4222
(603) 569-3950
(603) 569-6709
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
310400000X
Assisted Living Facility
02451
NH
311500000X
Alzheimer Center (Dementia Center)
02451
NH
313M00000X
Nursing Facility/Intermediate Care Facility
02451
NH
314000000X
Skilled Nursing Facility
Primary
02451
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000005BC
ANTHEM BLUE CROSS
—
01
—
4J47SU
MN BC/BS
MN
01
—
850370802
BC/BS
AL
01
—
850370802
GIC INDEMNITY
—
05
—
99750169
—
NH
Enumeration date
05/28/2006
Last updated
08/17/2018
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