Provider Demographics
NPI:1033437579
Name:WINDSOR SACRAMENTO ESTATES, LLC
Entity Type:Organization
Organization Name:WINDSOR SACRAMENTO ESTATES, LLC
Other - Org Name:WINDSOR CARE CENTER OF SACRAMENTO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ASH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAWLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-385-1078
Mailing Address - Street 1:9200 W SUNSET BLVD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-3502
Mailing Address - Country:US
Mailing Address - Phone:310-860-2284
Mailing Address - Fax:310-595-3752
Practice Address - Street 1:501 JESSIE AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-2608
Practice Address - Country:US
Practice Address - Phone:916-922-8855
Practice Address - Fax:916-922-6208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-07
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA030000043314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA555717Medicare Oscar/Certification