Healthcare Provider Details

I. General information

NPI: 1831235290
Provider Name (Legal Business Name): WINDSOR ROSEWOOD CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 OAK PARK BLVD
PLEASANT HILL CA
94523-4601
US

IV. Provider business mailing address

1911 OAK PARK BLVD
PLEASANT HILL CA
94523-4601
US

V. Phone/Fax

Practice location:
  • Phone: 925-935-6630
  • Fax: 925-933-0583
Mailing address:
  • Phone: 925-935-6630
  • Fax: 925-933-0583

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 FIEGEN
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 310-385-1090