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Organization

WINDSOR COUNTRY DRIVE CARE CENTER, LLC

Active
Other names
Windsor Country Drive 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
2500 COUNTRY DR, FREMONT, CA 94536-5356
(510) 792-4242
(510) 797-2074
Mailing address
2500 COUNTRY DR, FREMONT, CA 94536-5356
(510) 792-4242
(510) 797-2074

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZZR05885I
CA
Enumeration date
01/29/2007
Last updated
08/22/2020
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