Healthcare Provider Details

I. General information

NPI: 1801524830
Provider Name (Legal Business Name): KNOLLWOOD HEALTHCARE AND REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 08/09/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151A KNOLLWOOD DR
MOBILE AL
36693-2745
US

IV. Provider business mailing address

3151A KNOLLWOOD DR
MOBILE AL
36693-2745
US

V. Phone/Fax

Practice location:
  • Phone: 251-661-7608
  • Fax: 251-602-9146
Mailing address:
  • Phone: 251-661-7608
  • Fax: 251-602-9146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: EPHRAM LAHASKY
Title or Position: MEMBER
Credential:
Phone: 646-772-3668