# KNOLLS WEST ENTERPRISES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013914936
- **Authorized official:** MRS. STACY JEAN SANCHEZ (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (760) 245-5361

## Contact information

- **Practice address:** 16890 GREEN TREE BLVD, VICTORVILLE, CA 92395-5618
- **Practice address phone:** (760) 245-5361
- **Practice address fax:** (760) 245-6247
- **Mailing address:** 16890 GREEN TREE BLVD, VICTORVILLE, CA 92395-5618
- **Mailing address phone:** (760) 245-5361
- **Mailing address fax:** (760) 245-6247

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | CA | Yes |

## Other

- **Enumeration date:** 07/07/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC55251 | — | CA |