Gavilan Manor

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GAVILAN MANOR

Practice address

24195 Spencer Butte Dr
Perris, CA 92570-9844

Phone

(951) 347-2809

NPI assigned

Jul 8, 2024

Last updated

Jul 8, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Earlienne Rillo

Title

Director

Phone

(951) 533-6439

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1548006596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24195 SPENCER BUTTE DR",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925709844",
            "telephone_number": "951-347-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24195 SPENCER BUTTE DR",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925709844",
            "telephone_number": "951-347-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAVILAN MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "RILLO",
        "authorized_official_first_name": "EARLIENNE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "951-533-6439"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.