KNOLLS CONVALESCENT HOSPITAL INC
Assisted Living Facility
Victorville, California
Provider NPI: 1821095647
Organization Information:Organization Name: KNOLLS CONVALESCENT HOSPITAL INC
Practice Location:
14973 HESPERIA RD VICTORVILLE, CA 92395 US
Tel: 760-245-6477 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
14973 HESPERIA RD VICTORVILLE, CA 92395 US
Tel: 760-245-6477 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | CA |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
ZZT05076F | CA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin