Provider Demographics
NPI:1609341304
Name:KNOLLWOOD NH LLC
Entity Type:Organization
Organization Name:KNOLLWOOD NH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:HILL
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:404-790-1961
Mailing Address - Street 1:3151A KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-2745
Mailing Address - Country:US
Mailing Address - Phone:251-661-7608
Mailing Address - Fax:251-602-9146
Practice Address - Street 1:3151A KNOLLWOOD DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-2745
Practice Address - Country:US
Practice Address - Phone:251-661-7608
Practice Address - Fax:251-602-9146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility