Organization
SUNBRIDGE SALEM HEALTH CARE LLC
Active
Parent organization
SUNBRIDGE CARE ENTERPRISES LLC
Other names
Salem Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUNBRIDGE CARE ENTERPRISES LLC
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
255 SUNBRIDGE DR, SALEM, WV 26426-8400
(304) 782-3000
(304) 782-3003
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
313M00000X
Nursing Facility/Intermediate Care Facility
95
WV
314000000X
Skilled Nursing Facility
Primary
95
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000324428
BCBS
WV
05
—
0004029000
—
WV
Enumeration date
05/30/2006
Last updated
08/17/2018
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