# WINDSOR WILLOW TREE NURSING & REHAB CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Willow Tree Nursing & Rehab Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083081723
- **Authorized official:** LAWRENCE FEIGEN (MANAGING MEMBER)
- **Authorized official phone:** (310) 385-1090

## Contact information

- **Practice address:** 2124 57TH AVE, OAKLAND, CA 94621-4322
- **Practice address phone:** (510) 261-2628
- **Mailing address:** 2124 57TH AVE, OAKLAND, CA 94621-4322
- **Mailing address phone:** (510) 261-2628

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | CA | Yes |

## Other

- **Enumeration date:** 08/28/2015
- **Last updated:** 08/28/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 055876 | MEDICARE PROVIDER \# | CA |