Organization
GREENFIELD CARE CENTER OF FAIRFIELD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENQ H CHEN (CHAIRMAN/PRESIDENT)
(310) 889-9929
Entity
Organization
Contact information
Practice address
1260 TRAVIS BLVD, FAIRFIELD, CA 94533-4802
(707) 425-0669
Mailing address
1937 PONTIUS AVE, LOS ANGELES, CA 90025-5611
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
110000079
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZR05189G
—
CA
Enumeration date
10/03/2005
Last updated
08/08/2022
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