Healthcare Provider Details

I. General information

NPI: 1891872644
Provider Name (Legal Business Name): WINDSOR GARDENS CONVALESCENT HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 CRENSHAW BLVD
LOS ANGELES CA
90019-1938
US

IV. Provider business mailing address

915 CRENSHAW BLVD
LOS ANGELES CA
90019-1938
US

V. Phone/Fax

Practice location:
  • Phone: 323-937-5466
  • Fax: 323-939-6753
Mailing address:
  • Phone: 323-937-5466
  • Fax: 323-939-6753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. LAWRENCE FEIGEN
Title or Position: COO/CFO
Credential:
Phone: 310-385-1090