Provider Demographics
NPI:1144617861
Name:WESTCHESTER GARDENS LLC
Entity Type:Organization
Organization Name:WESTCHESTER GARDENS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANISHA
Authorized Official - Middle Name:MINESH
Authorized Official - Last Name:MISTRY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:661-549-9988
Mailing Address - Street 1:5306 RUSTIC CANYON ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-7313
Mailing Address - Country:US
Mailing Address - Phone:661-549-9988
Mailing Address - Fax:661-206-4063
Practice Address - Street 1:2228 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3603
Practice Address - Country:US
Practice Address - Phone:661-324-3091
Practice Address - Fax:661-206-4063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA155801189310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility