# CARROLL MANOR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184030629
- **Authorized official:** MRS. VIRGINIA MILLER (LICENSEE)
- **Authorized official phone:** (661) 944-1085

## Contact information

- **Practice address:** 38161 90TH ST E, LITTLEROCK, CA 93543-4012
- **Practice address phone:** (661) 944-1085
- **Mailing address:** 38161 90TH ST E, LITTLEROCK, CA 93543-4012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 191221245 | CA | Yes |

## Other

- **Enumeration date:** 07/04/2014
- **Last updated:** 07/04/2014