Healthcare Provider Details

I. General information

NPI: 1982089348
Provider Name (Legal Business Name): WINDSOR WESTLAKE HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 FAIRVIEW RD
THOUSAND OAKS CA
91361-2456
US

IV. Provider business mailing address

250 FAIRVIEW RD
THOUSAND OAKS CA
91361-2456
US

V. Phone/Fax

Practice location:
  • Phone: 805-494-1233
  • Fax:
Mailing address:
  • Phone: 805-494-1233
  • Fax:

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: MANAGING MEMBER
Credential:
Phone: 310-385-1090