San Bernardino Convalescent Operations Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SAN BERNARDINO CONVALESCENT OPERATIONS INC.

Doing business as

Legacy Post-Acute Rehabilitation Center

Practice address

1335 N Waterman Ave
San Bernardino, CA 92404-5312

Phone

(909) 885-0268

Fax

(909) 888-5982

NPI assigned

Sep 7, 2005

Last updated

Nov 13, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracey A Johns

Title

Business Office Manager

Phone

(909) 885-0268

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Legacy Post-Acute Rehabilitation Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1396739199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10487",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230487",
            "telephone_number": "909-885-0268",
            "fax_number": "909-884-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045312",
            "telephone_number": "909-885-0268",
            "fax_number": "909-888-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN BERNARDINO CONVALESCENT OPERATIONS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "909-885-0268"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC70122F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05708H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Post-Acute Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nosheen Samuel
• San Bernardino Anesthesia Medical Group, Inc.
• San Bernardino Care Company (Medical Center Convalescent Hospital)
• San Bernardino City Unified School District
• San Bernardino City Usd
• San Bernardino County (San Bernardino County Department of Public Health)
• San Bernardino County
• San Bernardino County
• San Bernardino County (San Bernardino County Fire Department)
• San Bernardino County (Arrowhead Regional Medical Center)

• Skilled Nursing Facility in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.