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Organization
SAN BERNARDINO CONVALESCENT OPERATIONS INC.
Active
Organization
SAN BERNARDINO CONVALESCENT OPERATIONS INC.
Active
Other names
Legacy Post-Acute Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY A JOHNS (BUSINESS OFFICE MANAGER)
(909) 885-0268
Entity
Organization
Contact information
Practice address
1335 N WATERMAN AVE, SAN BERNARDINO, CA 92404-5312
(909) 885-0268
(909) 888-5982
Mailing address
PO BOX 10487, SAN BERNARDINO, CA 92423-0487
(909) 885-0268
(909) 884-1722
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC70122F
—
CA
05
—
ZZT05708H
—
CA
Enumeration date
09/07/2005
Last updated
11/13/2007
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