Organization
VIBRA HOSPITAL OF SAN BERNARDINO, LLC
Active
Organization
VIBRA HOSPITAL OF SAN BERNARDINO, LLC
Active
Other names
Ballard Rehabilitation Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD EUGENE HOLLINGER (PRESIDENT)
(717) 591-5700
Entity
Organization
Contact information
Practice address
1760 W 16TH ST, SAN BERNARDINO, CA 92411-1160
(909) 473-1200
(909) 473-1276
Mailing address
PO BOX 26657, FRESNO, CA 93729-6657
(559) 892-2500
(559) 892-2444
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
240000502
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120321000
DEPT OF LABOR
—
05
—
1497748081
—
CA
01
—
ZZZH3608Z
BLUE SHIELD
—
Enumeration date
08/29/2005
Last updated
10/10/2023
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