Healthcare Provider Details

I. General information

NPI: 1285554923
Provider Name (Legal Business Name): 2044 WEST CARE MANOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2044 W AVENUE H6
LANCASTER CA
93536-8351
US

IV. Provider business mailing address

2044 W AVENUE H6
LANCASTER CA
93536-8351
US

V. Phone/Fax

Practice location:
  • Phone: 661-729-5324
  • Fax:
Mailing address:
  • Phone: 661-729-5324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MARIAN ANTONA
Title or Position: ADMINISTRATOR
Credential:
Phone: 909-996-6768