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Contact Information

SUNBRIDGE CLIPPER HOME OF WOLFEBORO LLC
39 CLIPPER DR
WOLFEBORO, NH03894-4222
 Phone: 603-569-3950
 Fax: 603-569-6709
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Alzheimer Center /Dementia Center/Dementia Special Care Unit

311500000X
 

Assisted Living Facility

310400000X
 

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for SUNBRIDGE CLIPPER HOME OF WOLFEBORO LLC

NPI # 1376590976
LBN Legal business name SUNBRIDGE CLIPPER HOME OF WOLFEBORO LLC
Authorized official MICHAEL BERG - (ASSISTANT SECRETARY)
Entity Organization
Organization subpart 1 Yes
Enumeration date 05/28/2006
Last updated 08/17/2018 - About 8 years ago
Identifiers
NH License # 02451
NH Medicaid 99750169
Other 0000005BC ANTHEM BLUE CROSS
Other 850370802 GIC INDEMNITY
Other 850370802 UNICARE INDEMNITY
AL Other 850370802 BC/BS
MN Other 4J47SU MN BC/BS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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