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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