Healthcare Provider Details

I. General information

NPI: 1285781013
Provider Name (Legal Business Name): WINDSOR CONVALESCENT AND REHABILITATION CENTER OF FREMONT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 PARKSIDE DR
FREMONT CA
94536-5332
US

IV. Provider business mailing address

2400 PARKSIDE DR
FREMONT CA
94536-5332
US

V. Phone/Fax

Practice location:
  • Phone: 510-793-7222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. CYNTHIA V CRUZ
Title or Position: ADMINISTRATOR
Credential: MHA, NHA
Phone: 510-793-7222