# KNOLLS WEST POST ACUTE LLC

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

## Provider details

- **NPI number:** 1588091383
- **Authorized official:** MR. DAVID JOHNSON (CEO)
- **Authorized official phone:** (310) 266-1080

## Contact information

- **Practice address:** 16890 GREEN TREE BLVD, VICTORVILLE, CA 92395-5618
- **Practice address phone:** (310) 266-1080
- **Practice address fax:** (714) 256-2003
- **Mailing address:** 530 N PUENTE ST, BREA, CA 92821-2804
- **Mailing address phone:** (310) 266-1080
- **Mailing address fax:** (714) 256-2003

## Taxonomy

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

## Other

- **Enumeration date:** 10/11/2013
- **Last updated:** 12/30/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC55251F | — | CA |