Provider Demographics
NPI:1497078877
Name:WINDSOR COURT ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:WINDSOR COURT ASSISTED LIVING, LLC
Other - Org Name:WINDSOR COURT ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RELLER-BROWNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:760-327-8351
Mailing Address - Street 1:201 SOUTH SUNRISE WAY
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6738
Mailing Address - Country:US
Mailing Address - Phone:760-327-8351
Mailing Address - Fax:760-327-8259
Practice Address - Street 1:201 SOUTH SUNRISE WAY
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6738
Practice Address - Country:US
Practice Address - Phone:760-327-8351
Practice Address - Fax:760-327-8259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336403366310400000X, 315D00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA336403366OtherDEPT. OF SOCIAL SERVICES