Healthcare Provider Details

I. General information

NPI: 1841126414
Provider Name (Legal Business Name): OAK HILLS MANOR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9928 DESMOND DR
OAK HILLS CA
92344-0931
US

IV. Provider business mailing address

2151 E CONVENTION CENTER WAY STE 222
ONTARIO CA
91764-5496
US

V. Phone/Fax

Practice location:
  • Phone: 909-838-1400
  • Fax:
Mailing address:
  • Phone: 909-354-8021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES H ERWIN
Title or Position: MEMBER / ADMINISTRATOR
Credential:
Phone: 909-838-1400