Organization
SUNBRIDGE HEALTHCARE LLC
Active
Other names
Estrella Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BERG (ASSISTANT SECRETARY)
(505) 821-3355
Entity
Organization
Contact information
Practice address
350 EAST LACANADA, AVONDALE, AZ 85323-1643
(623) 932-2282
(623) 925-8827
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
311500000X
Alzheimer Center (Dementia Center)
NCI378
AZ
314000000X
Skilled Nursing Facility
Primary
NCI378
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340547
—
AZ
01
—
AHCCCS ID #:340547
ARIZONA-MERCY CARE
AZ
Enumeration date
06/08/2006
Last updated
07/13/2015
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