Sunbridge of Harriman LLC
Organization Active NPI Skilled Nursing Facility · Harriman, TN
NPI 1124075650 · NPPES record last updated Sep 29, 2009
Key facts
- NPI
- 1124075650
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0000000212 (TN)
- Legal business name
- SUNBRIDGE OF HARRIMAN LLC
- Practice address
- 257 Patton LN
Harriman, TN 37748-8618 - Phone
- (865) 354-3941
- Fax
- (865) 354-9966
- NPI assigned
- May 29, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SUNBRIDGE HEALTHCARE CORPORATION
Authorized official
- Name
- William A. Mathies
- Title
- President Director
- Phone
- (505) 821-3355
Member of 2
National Provider Directory
- Part of
- Terrace Hghts Nursing H
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0000000212 | TN | Yes |
Addresses
Primary practice location
257 Patton LN
Harriman, TN 37748-8618
Mailing address
101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0093885 | Other | TN | BLUE CROSS/BLUE SHIELD OF |
| 100044717 | Other | PHP TENNCARE | |
| 1682240 | Other | CIGNA | |
| 445223 | Other | CARITEN | |
| 0445223 | Medicaid | TN | |
| 445223 | Other | CHAMP VA | |
| 7100143 | Other | UNITED HEALTHCARE | |
| 7440519 | Medicaid | TN |
Other names
- Renaissance Terrace Care and Rehabilitation Center
Other providers in Harriman, TN
- Jamey Stephens
- Steven a Crews, DO, PA
- Jennifer Stevens
- Summit Medical Group, PLLC
- Summit Medical Group, PLLC
- Amber Swymer
- Paul William Tappan
- Michael Chance Tedder
- Miriam B Tedder
- Tennessee Cancer Specialists PLLC
All providers in Harriman, TN · Skilled Nursing Facility in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.