Provider Demographics
NPI:1750059440
Name:DESERT WILLOW HEALTH AND REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:DESERT WILLOW HEALTH AND REHABILITATION CENTER LLC
Other - Org Name:DESERT WILLOW HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGULIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-942-3483
Mailing Address - Street 1:2420 KNAPP ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1006
Mailing Address - Country:US
Mailing Address - Phone:718-942-3483
Mailing Address - Fax:
Practice Address - Street 1:2701 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-3869
Practice Address - Country:US
Practice Address - Phone:719-561-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care