Provider Demographics
NPI:1093102840
Name:SOUTHERN KNIGHTS
Entity Type:Organization
Organization Name:SOUTHERN KNIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-351-8575
Mailing Address - Street 1:27919 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-6427
Mailing Address - Country:US
Mailing Address - Phone:281-351-8575
Mailing Address - Fax:281-351-1129
Practice Address - Street 1:27919 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6427
Practice Address - Country:US
Practice Address - Phone:281-351-8575
Practice Address - Fax:281-351-1129
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOMBALL SENIOR HOUSING PARTNERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX141727310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility