Healthcare Provider Details
I. General information
NPI: 1740326420
Provider Name (Legal Business Name): WINDSOR CHICO CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
188 COHASSET LN
CHICO CA
95926-2206
US
IV. Provider business mailing address
188 COHASSET LN
CHICO CA
95926-2206
US
V. Phone/Fax
- Phone: 530-343-6084
- Fax: 530-343-6090
- Phone: 530-343-6084
- Fax: 530-343-6090
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name: MR.
LAWRENCE
FIEGEN
Title or Position: CHIEF OPERATING OFFICE
Credential:
Phone: 310-385-1090