Knolls West Assisted Living, LLC.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

KNOLLS WEST ASSISTED LIVING, LLC.

Practice address

16890 Green Tree Blvd
Victorville, CA 92395-5618

Phone

(760) 245-0107

Fax

(760) 843-1861

NPI assigned

Nov 7, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terronsay Elyse Whaley, ADMINISTRATOR

Title

Administrator

Phone

(760) 245-0107

Specialties & licenses 1

Addresses

Other names 1

• Knolls West Assisted Living, LLC. Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1497578330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16890 GREEN TREE BLVD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955618",
            "telephone_number": "760-245-0107",
            "fax_number": "760-843-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16890 GREEN TREE BLVD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955618",
            "telephone_number": "760-245-0107",
            "fax_number": "760-843-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOLLS WEST ASSISTED LIVING, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "WHALEY",
        "authorized_official_first_name": "TERRONSAY",
        "authorized_official_middle_name": "ELYSE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "760-245-0107",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knolls West Assisted Living, LLC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Alivia Kline
• Adrianna Marie Kneefel
• Glenis Knight
• Diane L. Knipper
• Knolls Convalescent Hospital Inc
• Knolls West Enterprises
• Knolls West Post Acute LLC
• Linna C Ko, PHARM D
• Samuel H Ko, D.D.S.
• Stephen Kolakowski Jr., MD

• Assisted Living Facility in Victorville, CA
• Providers in Victorville, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.