Provider Demographics
NPI:1134770308
Name:WINDSOR HOUSE SENIOR LIVING LLC
Entity type:Organization
Organization Name:WINDSOR HOUSE SENIOR LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:COURY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:216-302-2719
Mailing Address - Street 1:14803 HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:BROOKPARK
Mailing Address - State:OH
Mailing Address - Zip Code:44142-3065
Mailing Address - Country:US
Mailing Address - Phone:216-302-2719
Mailing Address - Fax:216-803-1999
Practice Address - Street 1:14801 HOLLAND RD
Practice Address - Street 2:
Practice Address - City:BROOKPARK
Practice Address - State:OH
Practice Address - Zip Code:44142-3092
Practice Address - Country:US
Practice Address - Phone:216-302-2719
Practice Address - Fax:216-803-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-27
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility