Healthcare Provider Details

I. General information

NPI: 1902971906
Provider Name (Legal Business Name): WINNFIELD NURSING AND REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 12/08/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 1ST ST
WINNFIELD LA
71483-2945
US

IV. Provider business mailing address

PO BOX 428
ORCHARD PARK NY
14127-0428
US

V. Phone/Fax

Practice location:
  • Phone: 318-628-3533
  • Fax: 318-628-7600
Mailing address:
  • Phone: 716-662-4955
  • Fax: 716-667-9230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number903
License Number StateLA

VIII. Authorized Official

Name: MR. NORBERT A BENNETT
Title or Position: CO-CHIEF EXECUTIVE OFFICER
Credential:
Phone: 716-662-4955