Healthcare Provider Details

I. General information

NPI: 1942320957
Provider Name (Legal Business Name): WHITE DEER RUN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 N WEST END AVE # 55
LANCASTER PA
17603-3226
US

IV. Provider business mailing address

4020 ASPEN GROVE DR STE 900
FRANKLIN TN
37067-3134
US

V. Phone/Fax

Practice location:
  • Phone: 717-396-0650
  • Fax: 570-649-2206
Mailing address:
  • Phone: 615-861-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number367058
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number367058
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number367058
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number367058
License Number StatePA

VIII. Authorized Official

Name: BRIAN P. FARLEY
Title or Position: VICE PRESIDENT & SECRETARY
Credential:
Phone: 615-861-6000