# WINDSOR COUNTRY DRIVE CARE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Windsor Country Drive Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841336534
- **Authorized official:** MR. LAWRENCE FIEGEN (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (310) 385-1090

## Contact information

- **Practice address:** 2500 COUNTRY DR, FREMONT, CA 94536-5356
- **Practice address phone:** (510) 792-4242
- **Practice address fax:** (510) 797-2074
- **Mailing address:** 2500 COUNTRY DR, FREMONT, CA 94536-5356
- **Mailing address phone:** (510) 792-4242
- **Mailing address fax:** (510) 797-2074

## Taxonomy

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

## Other

- **Enumeration date:** 01/29/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZR05885I | — | CA |