NPIMap

Organization Active NPI

Windsor Gardens Convalescent Hospital, Inc

Doing business as Windsor Gardens Convalescent Hospital of Los Angeles

  • Skilled Nursing Facility
  • Los Angeles, CA
National Provider Identifier
1891872644
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WINDSOR GARDENS CONVALESCENT HOSPITAL, INC
Doing business as
Windsor Gardens Convalescent Hospital of Los Angeles
Practice address
915 Crenshaw Blvd
Los Angeles, CA 90019-1938
Phone
(323) 937-5466
Fax
(323) 939-6753
NPI assigned
Nov 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Lawrence Feigen
Title
Coo/Cfo
Phone
(310) 385-1090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X CA Primary

Addresses

Primary practice location

915 Crenshaw Blvd
Los Angeles, CA 90019-1938

Mailing address

915 Crenshaw Blvd
Los Angeles, CA 90019-1938
Phone (323) 937-5466

Other identifiers 1

IdentifierTypeStateIssuer
ZZT06194LMedicaidCA

Other names 1

  • Windsor Gardens Convalescent Hospital of Los Angeles Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625000331 CA Part A Provider - Skilled Nursing Facility 3072599547 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891872644. Details of each certification follow.

Skilled nursing facility certification: CCN 056194

Legal name
WINDSOR GARDENS CONVALESCENT HOSPITAL INC
Doing business as
WINDSOR GARDENS CONVALESCENT HOSPITAL OF LOS ANGELES
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 1, 1972
Last certification
Mar 2, 2025
Beds
98
Ownership / control type
Limited Liability Corporation
Organization structure
CorporationProprietary
Incorporated
Mar 9, 1990 in CA
Enrollment address
915 Crenshaw Blvd
Los Angeles, CA 90019-1938
Nursing home name
WINDSOR GARDENS CONVALESCENT HOSPITAL
Affiliated entity
WINDSOR

Care Compare: Nursing home

Medicare Care Compare
Listed as
Windsor Gardens Convalescent HospitalCCN 056194 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 1, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9892.0 residents per day on average
Chain
Windsor22 facilities in the chain
Penalties (3 years)
2Fines totaling $37,882

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0716684Windsor Gardens Convalescent Hospital of915 S Crenshaw Blvd, Los Angeles, CA 90019Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

915 Crenshaw Blvd
Los Angeles, CA 90019
Phone (323) 937-5466

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
9560 Pico LLC Organization, Los Angeles, CA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 50%
Jameel M Hourani Individual Operational/Managerial Control Feb 1, 1995
Adp of the SNF Feb 1, 1995
Pico Ar LLC Organization, Los Angeles, CA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 50%
Antelope Holdings II, LLC Organization, Los Angeles, CA LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 30, 2023 50%
Newgen Administrative Services, LLC Organization, Los Angeles, CA LLC Operational/Managerial Control Jun 30, 2023
Adp of the SNF Jun 27, 2025
Antelope Holdings III, LLC Organization, Los Angeles, CA LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 30, 2023 50%
Avrohom L Tress Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 50%
Corporate OfficerVice President Aug 14, 2023
Corporate DirectorDirector Aug 9, 2023
Pamela Shaw Individual Operational/Managerial Control Jun 30, 2023
Adp of the SNF Jun 30, 2023
Gedyon Mekonnen Individual Operational/Managerial Control Aug 5, 2024
Adp of the SNF Aug 5, 2024
Aaron H Robin Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 50%
Corporate OfficerPresident Aug 14, 2023
Corporate DirectorDirector Aug 9, 2023

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 43

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 43

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891872644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191938",
            "telephone_number": "323-937-5466",
            "fax_number": "323-939-6753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900191938",
            "telephone_number": "323-937-5466",
            "fax_number": "323-939-6753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDSOR GARDENS CONVALESCENT HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FEIGEN",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "COO/CFO",
        "authorized_official_telephone_number": "310-385-1090",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT06194L",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Windsor Gardens Convalescent Hospital of Los Angeles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.