Eastside Manor Inc. DBA Southern Oaks
NPI #1205249927 in Greenville, South Carolina
Provider Information
- NPI Number
- 1205249927
- Entity Type
- Organization
- Organization Name
- Eastside Manor Inc. DBA Southern Oaks
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Jun 10, 2014
- Last Updated
- Jun 10, 2014
Practice Location
- Address
- 120 ROPER MOUNTAIN ROAD EXT
- City
- Greenville
- State
- South Carolina
- ZIP Code
- 29615-4823
- Phone
- (864) 288-3271
Authorized Official
- Name
- MRS. GAIL ROBERTA BOUDREAU
- Title
- EXECUTIVE DIRECTOR
- Phone
- (864) 288-3271
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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