MEDICARE: KIOWA HILLS HEALTH AND REHABILITATION CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care

General Provider Information

NPI Number	:	1609544287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIOWA HILLS HEALTH AND REHABILITATION CENTER LLC

Provider Business Mailing Address
First Line	:	2420 KNAPP ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1006
Country	:	US
Telephone Number	:	718-942-3483
Fax Number	:

Provider Business Practice Location Address
First Line	:	924 W KIOWA ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-1424
Country	:	US
Telephone Number	:	719-636-5221
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ZISHA MARGULIES
Credential	:
Telephone Number	:	718-942-3483

Provider Enumeration Date	:	08/31/2021
Last Update Date	:	01/17/2023

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