Basic Information
| Provider Information | |||||||||
| NPI: | 1194225409 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | STONEBRIDGE HEALTH & REHABILITATION CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23700 COMMERCE PARK | ||||||||
| Address2: | |||||||||
| City: | BEACHWOOD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441225827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162925706 | ||||||||
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| Practice Location | |||||||||
| Address1: | 102 CHANDRA DR | ||||||||
| Address2: | |||||||||
| City: | DUNCANNON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170209745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178344111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2018 | ||||||||
| LastUpdateDate: | 01/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | WEISBERG | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2162925706 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SABER HEALTHCARE HOLDINGS, LLC | ||||||||
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| NPICertificationDate: | 01/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.