Organization
SUNBRIDGE HEALTHCARE LLC
Active
Other names
Keller Landing
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
813 KELLER LN, TUSCUMBIA, AL 35674-1110
(256) 383-1535
(256) 383-2471
Mailing address
813 KELLER LN, TUSCUMBIA, AL 35674-1110
(256) 383-1535
(256) 383-2471
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
17165
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01046
FIRST COMMUNITY
—
01
—
3103139
BCBS
TN
01
—
4005756
BCBS OF ALABAMA, PO BOC 9
AL
05
—
4757710S
—
AL
Enumeration date
05/10/2006
Last updated
03/30/2017
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