Provider Demographics
NPI:1275287781
Name:MCKNIGHT AND MCKNIGHT HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:MCKNIGHT AND MCKNIGHT HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-567-6766
Mailing Address - Street 1:5061 KIMI GRAY CT SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-5917
Mailing Address - Country:US
Mailing Address - Phone:202-558-8592
Mailing Address - Fax:
Practice Address - Street 1:5061 KIMI GRAY CT SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5917
Practice Address - Country:US
Practice Address - Phone:202-558-8592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC400322800380OtherDCRA