Southern Manor Rest Home, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

SOUTHERN MANOR REST HOME, INC.

Practice address

521 Davenport Rd
Rutherfordton, NC 28139

Phone

(909) 894-9185

NPI assigned

Mar 6, 2007

Last updated

Dec 13, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Seung Kwan Chai

Title

President/Administrator

Phone

(909) 894-9185

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1417087990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73",
            "city": "COLLEGEDALE",
            "state": "TN",
            "postal_code": "373150073",
            "telephone_number": "909-894-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 DAVENPORT RD",
            "city": "RUTHERFORDTON",
            "state": "NC",
            "postal_code": "28139",
            "telephone_number": "909-894-9185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MANOR REST HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "CHAI",
        "authorized_official_first_name": "SEUNG KWAN",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "909-894-9185"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheridan Anesthesia Healthcare of North Carolina, P.C.
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• Cynthia Johnson Snyder, LCSW
• Jacqueline Zimmerman Solt, MD
• Jason Soto, M.D.
• Spartanburg Medical Center (Medical Group of the Carolinas - Family Medicine - Rutherfordton)
• Robert George Stallings, M.D.
• Marcia Stanford, LCMHCA
• Miranda Clara Starnes, COTA/L
• Drew John Steiner, MD

• Adult Care Home Facility in Rutherfordton, NC
• Providers in Rutherfordton, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.