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General NPI Number Information
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NPI Number | 1770373755
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Entity Type | Organization
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Legal Business Name | SUNNY SANDS MANOR
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 2263 SUNNYSANDS DR
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City | PERRIS
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State | CA
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Zip | 92570
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Country | US
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Telephone | 210-323-1677
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Fax |
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Provider Business Mailing Address
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Address Line | 12930 ELM CREST CT
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City | YUCAIPA
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State | CA
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Zip | 92399-5704
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Country | US
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Telephone | 210-323-1677
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MARK HOWDER
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Credential | PARAMEDIC
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Telephone | 210-323-1677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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