Organization
SUNBRIDGE HEALTHCARE LLC
Active
Other names
Columbia Crest Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BERG (ASSISTANT SECRETARY)
(505) 821-3355
Entity
Organization
Contact information
Practice address
1100 E NELSON RD, MOSES LAKE, WA 98837-2360
(509) 765-6788
(509) 766-9405
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
NH1151
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4114427
—
WA
01
—
504
PREMERA BC/MSC
WA
Enumeration date
05/27/2006
Last updated
07/13/2015
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