SUNBRIDGE HEALTHCARE LLC
Assisted Living Facility
Nampa, Idaho
Provider NPI: 1790732337
Organization Information:Organization Name: SUNBRIDGE HEALTHCARE LLC
Practice Location:
2609 SUNNYBROOK DR NAMPA, ID 83686 US
Tel: 208-467-7298 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
2609 SUNNYBROOK DR NAMPA, ID 83686 US
Tel: 208-467-7298 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | ID | 46 |
N | 311Z00000X | Nursing & Custodial Care Facilities Custodial Care Facility | ID | 46 |
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | ID | 46 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
BLUE SHIELD OF IDAHO | 000010022479 | ID | 01 |
TRUE BLUE | 02188 | ID | 01 |
8056570 | ID | 05 | |
0029216 | ID | 05 | |
BLUE CROSS OF IDAHO | 02188 | ID | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin