NPIMap

Organization Active NPI

Whiteside Manor, Inc.

  • Substance Abuse Rehabilitation Facility
  • Riverside, CA
National Provider Identifier
1598864357
Registry record updated Apr 10, 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
2743 Orange St
Riverside, CA 92501-2538
Phone
(951) 686-9454
Fax
(951) 686-2303
NPI assigned
Sep 21, 2006
Last updated
Apr 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

2743 Orange St
Riverside, CA 92501-2538

Mailing address

2743 Orange St
Riverside, CA 92501-2538
Phone (951) 686-9454

Other practice location 1

2709 Orange St
Riverside, CA 92501-2538
Phone (951) 788-9515

Other practice location 2

2759 Orange St
Riverside, CA 92501-2538
Phone (951) 788-9515

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2275665Whiteside Manor2743 Orange Street, Riverside, CA 92501Certificate of waiverJan 24, 2027

National Provider Directory

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

Other organizations with this tax ID 3

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

Locations

2759 Orange St
Riverside, CA 92501
Phone (951) 788-9515

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523318400000",
    "number": "1598864357",
    "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",
            "telephone_number": "951-686-9454",
            "fax_number": "951-686-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2743 ORANGE ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925012538",
            "telephone_number": "951-686-9454",
            "fax_number": "951-686-2303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2709 Orange St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925012538",
            "country_code": "US",
            "telephone_number": "951-788-9515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2759 Orange St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925012538",
            "country_code": "US",
            "telephone_number": "951-788-9515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WHITESIDE MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2018-04-10",
        "status": "A",
        "authorized_official_last_name": "DOTSON",
        "authorized_official_first_name": "DORI",
        "authorized_official_title_or_position": "ADMIN MANAGER",
        "authorized_official_telephone_number": "951-788-9515"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.