# GREENFIELD CARE CENTER OF FAIRFIELD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396732590
- **Authorized official:** JENQ H CHEN (CHAIRMAN/PRESIDENT)
- **Authorized official phone:** (310) 889-9929

## Contact information

- **Practice address:** 1260 TRAVIS BLVD, FAIRFIELD, CA 94533-4802
- **Practice address phone:** (707) 425-0669
- **Mailing address:** 1937 PONTIUS AVE, LOS ANGELES, CA 90025-5611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 110000079 | CA | Yes |

## Other

- **Enumeration date:** 10/03/2005
- **Last updated:** 08/08/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZR05189G | — | CA |