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Organization
EASTSIDE MANOR INC. DBA SOUTHERN OAKS
Active
Organization
EASTSIDE MANOR INC. DBA SOUTHERN OAKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GAIL ROBERTA BOUDREAU (EXECUTIVE DIRECTOR)
(864) 288-3271
Entity
Organization
Contact information
Practice address
120 ROPER MOUNTAIN ROAD EXT, GREENVILLE, SC 29615-4823
(864) 288-3271
(864) 365-0697
Mailing address
120 ROPER MOUNTAIN ROAD EXT, GREENVILLE, SC 29615-4823
(864) 288-3271
(864) 365-0697
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
CRC0611
SC
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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