SOUTHSIDE RES. CARE (NPI# 1699929612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699929612 |
| Entity Type | Organization |
| Organization Name | SOUTHSIDE RES. CARE |
| Practice Address |
425 S. Wheeler Ave Pros SC 29127 |
| Mailing Address |
425 S. Wheeler Ave Prosperity SC 29127 |
| Practice Telephone | 8033640022 |
| Practice Fax Number | 8033648250 |
| Mailing Telephone | 8033640022 |
| Mailing Fax Number | 8033648250 |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2008-11-05 |
| Authorized Official Name | ROY L. BOWERS SR. (CEO) |
| Authorized Official Telephone | 8033640022 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Street Address |
425 S. WHEELER AVE |
| City | PROS |
| State | SC |
| Zip Code | 29127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932675147 | Kane Vaughn Summer | Pharmacist | 101 N Main Street, Prosperity, SC 29127 | 2018-10-16 |
| 1073050639 | Mid-carolina Dental Care, Inc | Dentist | 316 N Wheeler Ave, Prosperity, SC 29127 | 2017-01-20 |
| 1679970255 | Heather Shealy Mccormack | Registered Nurse | 5 Seibert Rd, Prosperity, SC 29127 | 2014-11-26 |
| 1811233901 | Laura Montgomery | Pharmacist | 101 N. Main St, Prosperity, SC 29127 | 2012-12-18 |
| 1710964416 | William M Dixon IIi | Family Medicine | 600 N Wheeler Ave, Prosperity, SC 29127 | 2005-12-23 |
| 1376889469 | Carmen Monts | Pharmacist | 101 N. Main St., Prosperity, SC 29127 | 2012-12-18 |
| 1932491966 | Prisma Health-midlands | Community/Behavioral Health | 600 N Wheeler Ave, Prosperity, SC 29127 | 2011-05-10 |
| 1114081734 | Palmetto Health | Counselor | 600 N Wheeler Ave, The Pastoral Counseling Center of Newberry County, Prosperity, SC 29127 | 2006-12-20 |
| 1215973334 | Pugh Drug Inc | Pharmacy | 101 N Main St, Prosperity, SC 29127 | 2006-06-20 |
| 1366429987 | Lovelace Family Medicine, Pa | Clinic/Center | 600 N Wheeler Ave, Prosperity, SC 29127 | 2005-12-23 |
| Find all providers in zip 29127 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124586599 | Lucille Manor Community Residential Care, LLP | Community Based Residential Treatment Facility, Mental Illness | 1004 R L Coward Rd, Eastover, SC 29044-9455 | 2019-03-05 |
| 1497290852 | Carolina Roses of Blythewood LLC | Community Based Residential Treatment Facility, Mental Illness | 5338 Hardscrabble Rd, Blythewood, SC 29016 | 2016-12-21 |
| 1568912285 | Cbh of Anderson, Operating, LLC | Community Based Residential Treatment Facility, Mental Illness | 313 Williams St, Williamston, SC 29697-1928 | 2016-10-05 |
| 1235592072 | Dodababy Inc | Community Based Residential Treatment Facility, Mental Illness | 1775 Commissary St, N Charleston, SC 29405-1905 | 2016-03-30 |
| 1962880690 | Butterfly Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1562 Fred Davis Road, Cheraw, SC 29520 | 2015-05-14 |
| 1144639881 | Mary's Angels Independent Living for Young Women | Community Based Residential Treatment Facility, Mental Illness | 29 Sunflower Dr, Cades, SC 29518-3312 | 2014-08-06 |
| 1730510066 | Elizabeth Bledsoe | Community Based Residential Treatment Facility, Mental Illness | 924 Barr Woods Rd, Saluda, SC 29138-8191 | 2013-12-12 |
| 1013256080 | Amikids Palmetto, Inc. | Community Based Residential Treatment Facility, Mental Illness | 780 T Bishop Rd, Jonesville, SC 29353-2342 | 2013-02-11 |
| 1811234206 | Carolina Health and Wellness | Community Based Residential Treatment Facility, Mental Illness | 317 Silver Fox Ln, Columbia, SC 29212-2491 | 2013-01-06 |
| 1033499827 | Joyce C Gregory | Community Based Residential Treatment Facility, Mental Illness | 2415 Fork Shoals Rd, Piedmont, SC 29673 | 2011-08-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.