NPI 1205249927

Eastside Manor INC. Dba Southern Oaks

Organisation Assisted Living Facility Greenville, SC

Practice location

Address: 120 Roper Mountain Road Ext, Greenville, SC 29615-4823
Phone: (864) 288-3271
Fax: (864) 365-0697

Authorised official

Name: Gail Roberta Boudreau
Title: Executive Director
Phone: (864) 288-3271

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence CRC0611 (SC)

Other Assisted Living Facility providers in South Carolina →

Registry record

NPI: 1205249927
Entity type: Organization
NPI issued: 10 Jun 2014
Record last updated: 10 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.