MEDICARE: WHITE HOUSE HEALTH SYSTEMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	251G00000X	Community Based Hospice Care Agency
3	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	EIN	OTHER	VA	BEHAVIORAL HEALTH SERVICES

General Provider Information

NPI Number	:	1326815374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITE HOUSE HEALTH SYSTEMS

Provider Business Mailing Address
First Line	:	PO BOX 7113
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-0113
Country	:	US
Telephone Number	:	757-262-2040
Fax Number	:	757-262-2070

Provider Business Practice Location Address
First Line	:	3321 W MERCURY BLVD STE D
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-3806
Country	:	US
Telephone Number	:	757-262-2040
Fax Number	:	757-262-2070

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NABILA SADIQUA WHITE
Credential	:	LPC
Telephone Number	:	757-763-7144

Provider Enumeration Date	:	12/11/2023
Last Update Date	:	12/22/2023

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Directions to “WHITE HOUSE HEALTH SYSTEMS ” Practice Location

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