Healthcare Provider Details

I. General information

NPI: 1154467835
Provider Name (Legal Business Name): WINDSOR CHICO CREEK CARE AND REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 04/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

587 RIO LINDO AVE
CHICO CA
95926-1816
US

IV. Provider business mailing address

587 RIO LINDO AVE
CHICO CA
95926-1816
US

V. Phone/Fax

Practice location:
  • Phone: 530-345-1306
  • Fax: 530-342-1353
Mailing address:
  • Phone: 530-345-1306
  • Fax: 530-342-1353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number230000046
License Number StateCA

VIII. Authorized Official

Name: MR. ASH CHAWLA
Title or Position: VP, FINANCE
Credential:
Phone: 310-385-1090