Healthcare Provider Details

I. General information

NPI: 1780129163
Provider Name (Legal Business Name): HILTON MANOR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2016
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 W HILTON AVE
REDLANDS CA
92373-7012
US

IV. Provider business mailing address

42 W HILTON AVE
REDLANDS CA
92373-7012
US

V. Phone/Fax

Practice location:
  • Phone: 909-353-2330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number550003708
License Number StateCA

VIII. Authorized Official

Name: MRS. ELEANOR POSNER
Title or Position: CEO
Credential:
Phone: 909-353-2330