NPIMap

Organization Active NPI

Whiteside Manor, Inc.

  • Substance Abuse Rehabilitation Facility
  • Riverside, CA
National Provider Identifier
1376081323
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
WHITESIDE MANOR, INC.
Practice address
2452 Wilshire St
Riverside, CA 92501-2144
Phone
(951) 682-6631
NPI assigned
Feb 9, 2017
Organization subpart
Yes
Parent organization
WHITESIDE MANOR, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dori Dotson
Title
Admin
Phone
(951) 788-9515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

2452 Wilshire St
Riverside, CA 92501-2144

Mailing address

2743 Orange St
Riverside, CA 92501-2538

Other practice location 1

2456 Wilshire Street
Riverside, CA 92501
Phone (951) 683-6631

Other names 1

  • Wilshire House Other name

National Provider Directory

National Provider Directory
Tax ID family
Whiteside Manor Palm Facility4 organizations share this tax ID, including this one
Part of
Whiteside Manor Palm Facility

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1376081323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2743 ORANGE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925012538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2452 WILSHIRE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925012144",
            "telephone_number": "951-682-6631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2456 Wilshire Street",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "92501",
            "country_code": "US",
            "telephone_number": "951-683-6631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WHITESIDE MANOR, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHITESIDE MANOR, INC.",
        "enumeration_date": "2017-02-09",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "DOTSON",
        "authorized_official_first_name": "DORI",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "951-788-9515"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilshire House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.