MEDICARE: SUNLAND MANOR INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1912675638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNLAND MANOR INC

Provider Business Mailing Address
First Line	:	10540 SHERMAN GROVE AVE
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-1913
Country	:	US
Telephone Number	:	818-352-5941
Fax Number	:

Provider Business Practice Location Address
First Line	:	10540 SHERMAN GROVE AVE
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-1913
Country	:	US
Telephone Number	:	818-352-5941
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ARYENTZVI ROSNER
Credential	:
Telephone Number	:	818-352-5941

Provider Enumeration Date	:	08/30/2021
Last Update Date	:	08/30/2021

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Directions to “SUNLAND MANOR INC ” Practice Location

Language	Start Address	Practice Location

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