Healthcare Provider Details

I. General information

NPI: 1992996730
Provider Name (Legal Business Name): WHITE DEER RUN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 COVE FORGE ROAD
WILLIAMSBURG PA
16693-9673
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 800-873-2131
  • Fax:
Mailing address:
  • Phone: 615-861-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number077009
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number077009
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number077009
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number077009
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number077009
License Number StatePA

VIII. Authorized Official

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