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Organization

SUNBRIDGE HEALTHCARE LLC

Active
Other names
Meridian Center
Organization subpart
No

Provider details

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

Contact information

Practice address
1351 W PINE AVE, MERIDIAN, ID 83642-5031
(208) 888-7049
(208) 888-7246
Mailing address
1351 W PINE AVE, MERIDIAN, ID 83642-5031
(208) 888-7049
(208) 888-7246

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
75
ID
314000000X
Skilled Nursing Facility
Primary
75
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8041302
ID
05
805698600
ID
Enumeration date
05/27/2006
Last updated
03/27/2017
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