Organization
WINDSOR WILLOW TREE NURSING & REHAB CENTER, LLC
Active
Other names
Willow Tree Nursing & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE FEIGEN (MANAGING MEMBER)
(310) 385-1090
Entity
Organization
Contact information
Practice address
2124 57TH AVE, OAKLAND, CA 94621-4322
(510) 261-2628
Mailing address
2124 57TH AVE, OAKLAND, CA 94621-4322
(510) 261-2628
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055876
MEDICARE PROVIDER #
CA
Enumeration date
08/28/2015
Last updated
08/28/2015
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