Organization
KNOLLS WEST ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACY JEAN SANCHEZ (CHIEF FINANCIAL OFFICER)
(760) 245-5361
Entity
Organization
Contact information
Practice address
16890 GREEN TREE BLVD, VICTORVILLE, CA 92395-5618
(760) 245-5361
(760) 245-6247
Mailing address
16890 GREEN TREE BLVD, VICTORVILLE, CA 92395-5618
(760) 245-5361
(760) 245-6247
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55251
—
CA
Enumeration date
07/07/2005
Last updated
08/22/2020
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