Organization Name: | PRINCIPAL KNOX LLC |
NPI Number: | 1508919903 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM M GRACEY (CHIEF OPERATING OFFICER) |
Mailing Address: | 102 E Culver Rd Knox |
State: | IN US |
Postal Code: | 465342216 |
Phone Number: | 5747726231 |
Fax Number: | |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 09/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |