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General NPI Number Information
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NPI Number | 1255255949
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Entity Type | Organization
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Legal Business Name | SUNRISE MANOR LLC
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 441 W CHANNEL ISLANDS BLVD
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City | OXNARD
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State | CA
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Zip | 93033-4407
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Country | US
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Telephone | 805-240-7600
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Fax | 805-240-9945
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Provider Business Mailing Address
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Address Line | 441 W CHANNEL ISLANDS BLVD
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City | OXNARD
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State | CA
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Zip | 93033-4407
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Country | US
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Telephone | 805-240-7600
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Fax | 805-240-9945
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Authorized Official
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Title or Position | HEAD ADMINISTRATOR
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Name | STACEY K MEDINA
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Credential |
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Telephone | 213-503-1998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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