Organization
WINDSOR VALLEJO CARE CENTER, LLC
Active
Other names
Windsor Vallejo Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE FIEGEN (CHIEF OPERATING OFFICER)
(310) 385-1090
Entity
Organization
Contact information
Practice address
2200 TUOLUMNE ST, VALLEJO, CA 94589-2523
(707) 644-7401
(707) 558-8165
Mailing address
2200 TUOLUMNE ST, VALLEJO, CA 94589-2523
(707) 644-7401
(707) 558-8165
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZR06238I
—
CA
Enumeration date
01/30/2007
Last updated
08/22/2020
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