Healthcare Provider Details
I. General information
NPI: 1497078877
Provider Name (Legal Business Name): WINDSOR COURT ASSISTED LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2010
Last Update Date: 03/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 SOUTH SUNRISE WAY
PALM SPRINGS CA
92262-6738
US
IV. Provider business mailing address
201 SOUTH SUNRISE WAY
PALM SPRINGS CA
92262-6738
US
V. Phone/Fax
- Phone: 760-327-8351
- Fax: 760-327-8259
- Phone: 760-327-8351
- Fax: 760-327-8259
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | 336403366 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 315D00000X |
| Taxonomy | Inpatient Hospice |
| License Number | 336403366 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | 336403366 |
| License Number State | CA |
VIII. Authorized Official
Name: MRS.
JEANNE
L.
RELLER-BROWNSTEIN
Title or Position: ADMINISTRATOR
Credential: R.N.
Phone: 760-327-8351