Knolls Convalescent Hospital Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

KNOLLS CONVALESCENT HOSPITAL INC

Practice address

14973 Hesperia Rd
Victorville, CA 92395-3923

Phone

(760) 245-6477

Fax

(760) 245-6247

NPI assigned

Jul 7, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Stacy Jean Sanchez

Title

Chief Financial Officer

Phone

(760) 245-5361

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Desert Knolls Convalescent Hospital Doing business as

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821095647",
    "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": "760-245-5361",
            "fax_number": "760-245-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14973 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953923",
            "telephone_number": "760-245-6477",
            "fax_number": "760-245-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOLLS CONVALESCENT HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "760-245-5361",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05076F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Knolls Convalescent Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neland Kisinger, PNP
• Alivia Kline
• Adrianna Marie Kneefel
• Glenis Knight
• Diane L. Knipper
• Knolls West Assisted Living, LLC.
• Knolls West Enterprises
• Knolls West Post Acute LLC
• Linna C Ko, PHARM D
• Samuel H Ko, D.D.S.

• 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 Aug 22, 2020; 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.