Provider Demographics
NPI:1013622216
Name:INLAND SENIOR MANOR INC.
Entity type:Organization
Organization Name:INLAND SENIOR MANOR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MA. TERESA
Authorized Official - Middle Name:V
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-350-8537
Mailing Address - Street 1:25871 SUN CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92586-2662
Mailing Address - Country:US
Mailing Address - Phone:562-350-8537
Mailing Address - Fax:
Practice Address - Street 1:25871 SUN CITY BLVD
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92586-2662
Practice Address - Country:US
Practice Address - Phone:562-350-8537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility