Organization
KNOLLWOOD HEALTHCARE LLC
Active
Parent organization
BRENTWOOD HEALTHCARE HOLDINGS LLC
Other names
Gordon Oaks Healthcare Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRENTWOOD HEALTHCARE HOLDINGS LLC
Authorized official
TYGH BROGDON (MANAGER)
(770) 650-8773
Entity
Organization
Contact information
Practice address
3151 KNOLLWOOD DR # A, MOBILE, AL 36693-2753
(251) 661-7608
Mailing address
3151 KNOLLWOOD DR # A, MOBILE, AL 36693-2753
(251) 661-7608
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N4926
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47579902
—
AL
Enumeration date
01/16/2008
Last updated
02/27/2008
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