Organization
SUNBRIDGE MOUNTAIN CARE MANAGEMENT LLC
Active
Parent organization
SUNBRIDGE HEALTHCARE LLC
Other names
New Martinsville 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
225 RUSSELL AVE, NEW MARTINSVILLE, WV 26155-1572
(304) 455-2600
(304) 455-2580
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
99
WV
314000000X
Skilled Nursing Facility
Primary
99
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015198000
—
WV
01
—
001703864
BCBS
WV
Enumeration date
05/30/2006
Last updated
08/17/2018
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