NPIMap

Organization Active NPI

Sunbridge Meadowbrook Rehabilitation Center

  • Skilled Nursing Facility
  • Los Angeles, CA
National Provider Identifier
1891742946
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
910000080 Issued in CA
Legal business name
SUNBRIDGE MEADOWBROOK REHABILITATION CENTER
Practice address
3951 East Blvd
Los Angeles, CA 90066-4605
Phone
(310) 391-8266
Fax
(310) 390-9878
NPI assigned
May 27, 2006
Organization subpart
Yes
Parent organization
SUNBRIDGE HEALTHCARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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

Authorized official

Name
Thomas Divitorrio
Title
Cfo, Treasurer, Asst Secretary
Phone
(505) 468-4742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 910000080 CA Primary

Addresses

Primary practice location

3951 East Blvd
Los Angeles, CA 90066-4605

Mailing address

101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604

Other identifiers 1

IdentifierTypeStateIssuer
ZZT05727GMedicaidCA

Other names 1

  • Meadowbrook Behavioral Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lewis Garcia2 organizations share this tax ID, including this one
Part of
Terrace Hghts Nursing H

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416528000000",
    "number": "1891742946",
    "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": "3951 EAST BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900664605",
            "telephone_number": "310-391-8266",
            "fax_number": "310-390-9878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNBRIDGE MEADOWBROOK REHABILITATION CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE LLC",
        "enumeration_date": "2006-05-27",
        "last_updated": "2014-11-21",
        "status": "A",
        "authorized_official_last_name": "DIVITORRIO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CFO, TREASURER, ASST SECRETARY",
        "authorized_official_telephone_number": "505-468-4742"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "910000080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05727G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meadowbrook Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.