Organization
M KNIGHT INC
Active
Other names
Chardonnay Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ALAN KNIGHT PHARMD (OWNER/ADMINISTRATOR)
(208) 736-4808
Entity
Organization
Contact information
Practice address
1045 CARRIAGE LN, TWIN FALLS, ID 83301-6751
(208) 736-4808
(208) 736-4809
Mailing address
1045 CARRIAGE LN, TWIN FALLS, ID 83301-6751
(208) 736-4808
(208) 736-4809
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
RC-961
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8082996
—
ID
Enumeration date
07/15/2010
Last updated
07/15/2010
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