Organization
SUNBRIDGE MEADOWBROOK REHABILITATION CENTER
Active
Parent organization
SUNBRIDGE HEALTHCARE LLC
Other names
Meadowbrook Behavioral Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUNBRIDGE HEALTHCARE LLC
Authorized official
THOMAS DIVITORRIO (CFO, TREASURER, ASST SECRETARY)
(505) 468-4742
Entity
Organization
Contact information
Practice address
3951 EAST BLVD, LOS ANGELES, CA 90066-4605
(310) 391-8266
(310) 390-9878
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
314000000X
Skilled Nursing Facility
Primary
910000080
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05727G
—
CA
Enumeration date
05/27/2006
Last updated
11/21/2014
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