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General NPI Number Information
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NPI Number | 1194124503
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Entity Type | Organization
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Legal Business Name | KNOPP ASSISTED LIVING CENTER, INC
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 202 BILLIE DR
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City | FREDERICKSBURG
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State | TX
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Zip | 78624-5056
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Country | US
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Telephone | 830-997-7924
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Fax | 888-550-4105
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Provider Business Mailing Address
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Address Line | 202 BILLIE DR
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City | FREDERICKSBURG
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State | TX
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Zip | 78624-5056
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Country | US
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Telephone | 830-997-7924
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Fax | 888-550-4105
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Authorized Official
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Title or Position | BILLING ADMINISTRATOR
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Name | ROSALIND G CORNJEO
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Credential |
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Telephone | 830-997-3704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 136912
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License Number State | TX
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