Healthcare Provider Details
I. General information
NPI: 1386890713
Provider Name (Legal Business Name): WHITE DEER RUN LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2008
Last Update Date: 06/28/2025
Certification Date: 06/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
OPEN BUILDING NUMBER 13 TORRANCE STATE HOSPITAL
TORRANCE PA
15779
US
IV. Provider business mailing address
PO BOX G BUILDING #13
TORRANCE PA
15779-0114
US
V. Phone/Fax
- Phone: 724-459-9700
- Fax:
- Phone: 724-459-9700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
P.
FARLEY
Title or Position: VICE PRESIDENT & SECRETARY
Credential:
Phone: 615-861-6000