Basic Information
| Provider Information | |||||||||
| NPI: | 1497293070 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WINDSOR ARVIN HEALTHCARE, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | WINDSOR POST-ACUTE CENTER OF ARVIN | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9200 WEST SUNSET BLVD | ||||||||
| Address2: | 700 | ||||||||
| City: | WEST HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900693603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103851090 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 323 CAMPUS DRIVE | ||||||||
| Address2: | |||||||||
| City: | ARVIN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6618544475 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2017 | ||||||||
| LastUpdateDate: | 04/27/2017 | ||||||||
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| AuthorizedOfficialLastName: | FEIGEN | ||||||||
| AuthorizedOfficialFirstName: | LAWRENCE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 3103851090 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | CA | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.