Sunbridge Braswell Enterprises, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

240000117 Issued in CA

Legal business name

SUNBRIDGE BRASWELL ENTERPRISES, INC.

Doing business as

Sierra Vista

Practice address

3455 Highland Ave
Highland, CA 92346-2214

Phone

(909) 862-6454

Fax

(909) 862-6474

NPI assigned

May 26, 2006

Last updated

Jul 14, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

SUNBRIDGE HEALTHCARE CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William A. Mathies

Title

Prresident Director

Phone

(505) 821-3355

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sierra Vista Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Laurel Park Behavioral Health Center3 organizations share this tax ID, including this one

Part of

Sunrise HLTH Care Corp

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Sunbridge Braswell Enterprises LLC

  dba Olive Vista, Ctr for Problems of Lvgs

  • Skilled Nursing Facility
  • Pomona, CA
  • NPI 1336196484
  NPD tax ID
• Sunbridge Braswell Enterprises LLC

  dba Laurel Park Behavioral Health Center

  • Skilled Nursing Facility
  • Pomona, CA
  • NPI 1639126782
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247529600000",
    "number": "1326094665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "address_2": "COMPLIANCE DEPARTMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 HIGHLAND AVE",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923462214",
            "telephone_number": "909-862-6454",
            "fax_number": "909-862-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNBRIDGE BRASWELL ENTERPRISES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE CORPORATION",
        "enumeration_date": "2006-05-26",
        "last_updated": "2009-07-14",
        "status": "A",
        "authorized_official_last_name": "MATHIES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRRESIDENT DIRECTOR",
        "authorized_official_telephone_number": "505-821-3355"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "240000117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT18562K",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sierra Vista",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Raymond Stinson, O.D.
• Claudia K. Stoll, P.A.
• Richard M. Strong, M.D.
• Rahab Njeri Sullivan, LVN
• Wenyu Sun, MD
• Renata Swanston, D.O.
• Philip Joseph Swiderski
• Baraa Taleb, RPH
• Kyera E Tate
• Teletherapeutics Health Ca Corp

• Skilled Nursing Facility in Highland, CA
• Providers in Highland, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.