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Southside Manor Inc.
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pomona, California
NPI 1528298502

Southside Manor Inc. is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Pomona, CA. Southside Manor Inc. practices in Pomona, CA. The NPI Number for Southside Manor Inc. is 1528298502 and holds a License No. 191502984 (California).

The current practice location address for Southside Manor Inc. is 820 E Grand Ave, Pomona, CA and can be reached out via phone at 909-623-7305 and via fax at 909-623-7898.

Location: 820 E Grand Ave, Pomona, CA, 91766-3662
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1528298502
Provider Name
Southside Manor Inc.
Credential
Provider Entity Type
Organization
Address
820 E Grand Ave, Pomona, CA, 91766-3662
Phone Number
909-623-7305
Fax Number
909-623-7898
Provider Enumeration Date
07/23/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
320900000X 01 CA DOMICILIARY CARE FACITITIY
institution
Provider Business Practice Location Address Details
Address
820 E Grand Ave
City
Pomona
State
California
Zip
91766-3662
Phone Number
909-623-7305
Fax Number
909-623-7898
person
Provider Business Mailing Address Details
Address
820 E Grand Ave
City
Pomona
State
California
Zip
91766-3662
Phone Number
909-623-7305
Fax Number
909-623-7898
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
191502984 (California)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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