Healthcare Provider Details

I. General information

NPI: 1124104872
Provider Name (Legal Business Name): WINDSOR GARDENS HEALTHCARE CTR OF HAYWARD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1628 B ST
HAYWARD CA
94541-3020
US

IV. Provider business mailing address

1628 B ST
HAYWARD CA
94541-3020
US

V. Phone/Fax

Practice location:
  • Phone: 510-582-4636
  • Fax:
Mailing address:
  • Phone: 510-582-4636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number020000062
License Number StateCA

VIII. Authorized Official

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