Provider Demographics
NPI:1437146073
Name:WINDSOR HEALTH CARE II CORP
Entity Type:Organization
Organization Name:WINDSOR HEALTH CARE II CORP
Other - Org Name:CHANDLER NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER'S REPRESENTAIVE
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:952-837-0818
Mailing Address - Street 1:300 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:TX
Mailing Address - Zip Code:75758-9636
Mailing Address - Country:US
Mailing Address - Phone:903-849-2485
Mailing Address - Fax:903-849-6228
Practice Address - Street 1:300 CHERRY ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:TX
Practice Address - Zip Code:75758-9636
Practice Address - Country:US
Practice Address - Phone:903-849-2485
Practice Address - Fax:903-849-6228
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINDSOR HEALTH CARE II CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-29
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110098314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45-5910Medicare Oscar/Certification