Organization
WHITESIDE MANOR, PALM FACILITY
Active
Parent organization
WHITESIDE MANOR
Organization subpart
Yes
Provider details
NPI number
Legal business name
WHITESIDE MANOR
Authorized official
DORI DOTSON (ADMINISTRATIVE MANAGER)
(951) 847-8010
Entity
Organization
Contact information
Practice address
4750 PALM AVE, RIVERSIDE, CA 92501-4012
(951) 788-9515
Mailing address
2743 ORANGE ST, RIVERSIDE, CA 92501-2538
(951) 788-9515
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/13/2016
Last updated
10/13/2016
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