Sunbridge Clipper Home of Wolfeboro LLC
Organization Active NPI Skilled Nursing Facility · Wolfeboro, NH
NPI 1376590976 · NPPES record last updated Aug 17, 2018
Key facts
- NPI
- 1376590976
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 02451 (NH)
- Legal business name
- SUNBRIDGE CLIPPER HOME OF WOLFEBORO LLC
- Practice address
- 39 Clipper Dr
Wolfeboro, NH 03894-4222 - Phone
- (603) 569-3950
- Fax
- (603) 569-6709
- NPI assigned
- May 28, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SUNBRIDGE HEALTHCARE LLC
Authorized official
- Name
- Michael Berg
- Title
- Assistant Secretary
- Phone
- (505) 468-4742
Corporate family (same tax ID) 27
Member of 1
Practitioners 1
National Provider Directory
- Tax ID family
- Terrace Hghts Nursing H
- Part of
- Terrace Hghts Nursing H
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 02451 | NH | |
| Alzheimer Center (Dementia Center) | 311500000X | 02451 | NH | |
| Nursing Facility/Intermediate Care Facility | 313M00000X | 02451 | NH | |
| Skilled Nursing Facility | 314000000X | 02451 | NH | Yes |
Addresses
Primary practice location
39 Clipper Dr
Wolfeboro, NH 03894-4222
Mailing address
101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 850370802 | Other | GIC INDEMNITY | |
| 0000005BC | Other | ANTHEM BLUE CROSS | |
| 4J47SU | Other | MN | MN BC/BS |
| 850370802 | Other | UNICARE INDEMNITY | |
| 99750169 | Medicaid | NH | |
| 850370802 | Other | AL | BC/BS |
Other names
- Wolfeboro Bay Center
Other providers in Wolfeboro, NH
- Daniel P Steele
- Mallory Stephens
- Amanda J Stevens
- Bonnie B. Stinson
- Deborah A Stone
- Synergistic Bodywork LLC
- Renee Tetreault
- Bethany Thayer
- Susan L Therriault
- Sarah B. Titus-Smith
All providers in Wolfeboro, NH · Skilled Nursing Facility in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2018. 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.