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Organization
PROFESSIONAL REHABILITATION HOSPITAL LLC
Active
Organization
PROFESSIONAL REHABILITATION HOSPITAL LLC
Active
Other names
RiverBridge Specialty Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
SONJA SHARP WATKINS (CHIEF FINANCIAL OFFICER)
(601) 824-9010
Entity
Organization
Contact information
Practice address
209 FRONT ST, VIDALIA, LA 71373-2837
(318) 336-6500
Mailing address
PO BOX 1499, BRANDON, MS 39043-1499
(601) 824-9010
(601) 824-9044
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
—
—
275N00000X
Medicare Defined Swing Bed Hospital Unit
—
—
282E00000X
Long Term Care Hospital
518
LA
282E00000X
Long Term Care Hospital
Primary
654
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1764914
—
LA
01
—
60973
BLUE CROSS PROVIDER #
LA
Enumeration date
04/03/2006
Last updated
03/25/2025
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