Healthcare Provider Details

I. General information

NPI: 1437045713
Provider Name (Legal Business Name): WINTER WOODS COTTAGES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 W LA CADENA DR
RIVERSIDE CA
92501-1340
US

IV. Provider business mailing address

845 W LA CADENA DR
RIVERSIDE CA
92501-1340
US

V. Phone/Fax

Practice location:
  • Phone: 646-523-9208
  • Fax:
Mailing address:
  • Phone: 646-523-9208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: YUSEF NOFAL
Title or Position: ADMIN/ OWNER
Credential:
Phone: 646-523-8208