Provider Demographics
NPI:1093459893
Name:WINDERMERE HEALTH CENTER BY HARBORVIEW, LLC
Entity Type:Organization
Organization Name:WINDERMERE HEALTH CENTER BY HARBORVIEW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEIBOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-804-1661
Mailing Address - Street 1:3618 J DEWEY GRAY CIR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-1867
Mailing Address - Country:US
Mailing Address - Phone:706-860-7572
Mailing Address - Fax:
Practice Address - Street 1:3618 J DEWEY GRAY CIR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-1867
Practice Address - Country:US
Practice Address - Phone:706-860-7572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility