Organization
OAK KNOLL CONVALESCENT CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY R. MEYERS (CEO)
(707) 778-8686
Entity
Organization
Contact information
Practice address
450 HAYES LN, PETALUMA, CA 94952-4010
(707) 778-8686
(707) 778-6111
Mailing address
450 HAYES LN, PETALUMA, CA 94952-4010
(707) 778-8686
(707) 778-6111
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
010000053
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55172F
—
CA
Enumeration date
09/16/2005
Last updated
12/30/2011
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