Provider Demographics
NPI:1639126287
Name:SUNBRIDGE BRITTANY REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:SUNBRIDGE BRITTANY REHABILITATION CENTER LLC
Other - Org Name:AMERICAN RIVER CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-468-4742
Mailing Address - Street 1:101 SUN AVE NE
Mailing Address - Street 2:COMPLIANCE DEPARTMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4373
Mailing Address - Country:US
Mailing Address - Phone:505-468-5604
Mailing Address - Fax:505-468-4681
Practice Address - Street 1:3900 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-6647
Practice Address - Country:US
Practice Address - Phone:916-481-6455
Practice Address - Fax:916-481-6489
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNBRIDGE HEALTHCARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-28
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30000404314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC55450FMedicaid
CA=========OtherBLUE SHILED
CA=========OtherCOLONIAL PENN LIFE
CA=========OtherGOLDEN STATE MEDICAL GROU
CA=========OtherAARP
CA=========OtherJOHN HANCOCK
CA=========OtherAMERICAN POSTAL WORKERS
CA=========OtherCHAMPUS
CA=========OtherMETLIFE
CA=========OtherAETNA HEALTHCARE
CA=========OtherGEHA
CA=========OtherHARTFORD LIFE
CA=========OtherHEALTH NET
CA=========OtherCIGNA
CA=========OtherPRUDENTIAL
CALTC55450FMedicaid
CA=========OtherBLUE CROSS
CA=========OtherPIONEER LIFE
CA=========OtherAETNA HEALTHCARE
CA=========OtherAMERICAN POSTAL WORKERS