Southside Manor Inc.
LBN: Southside Manor Inc.
Southside Manor Inc. is an health care organization with primary practice located at 820 E Grand Ave , Pomona CA 91766-3662. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty.
Southside Manor Inc. can be contacted via phone (909) 623-7305, or through Pardue, James via phone (909) 623-7305.
Contact Information
Primary practice address
820 E Grand Ave
Pomona CA 91766-3662
Phone: (909) 623-7305
Fax: (909) 623-7898
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320900000X | 191502984 | California |
Profile Details
| NPI number | 1528298502 |
|---|---|
| LBN Legal business name | Southside Manor Inc. |
| DBA Doing business as | |
| Authorized official | Pardue, James |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 23rd, 2009 |
| Last updated | Aug 26th, 2009 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528298502 | NPPES |
| California | Other | 320900000X | DOMICILIARY CARE FACITITIY |
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