Healthcare Provider Details

I. General information

NPI: 1871584235
Provider Name (Legal Business Name): KNOPP HEALTHCARE & REHAB CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 04/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 N LLANO ST
FREDERICKSBURG TX
78624-3514
US

IV. Provider business mailing address

1208 N LLANO ST
FREDERICKSBURG TX
78624-3514
US

V. Phone/Fax

Practice location:
  • Phone: 830-997-3704
  • Fax: 830-990-4731
Mailing address:
  • Phone: 830-997-3704
  • Fax: 830-997-5245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number115113
License Number StateTX

VIII. Authorized Official

Name: MRS. JANE I PERRY
Title or Position: ADMINISTRATOR/OWNER
Credential:
Phone: 830-997-3704