Provider Demographics
NPI:1639235708
Name:KNOB HILL ASSISTED LIVING CENTER, INC.
Entity Type:Organization
Organization Name:KNOB HILL ASSISTED LIVING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:T
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:706-359-1115
Mailing Address - Street 1:2818 KNOB HILL FARM RD
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-6618
Mailing Address - Country:US
Mailing Address - Phone:706-860-0556
Mailing Address - Fax:706-868-8572
Practice Address - Street 1:2818 KNOB HILL FARM RD
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-6618
Practice Address - Country:US
Practice Address - Phone:706-860-0556
Practice Address - Fax:706-868-8572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility