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General NPI Number Information
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NPI Number | 1316128424
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Entity Type | Organization
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Legal Business Name | WHITE & ASSOCIATES CONSUMER DIRECTED SERVICES, LLC
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 1905 TRUMAN BLVD
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City | CARUTHERSVILLE
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State | MO
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Zip | 63830-2444
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Country | US
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Telephone | 573-333-0084
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 902
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City | CARUTHERSVILLE
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State | MO
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Zip | 63830-0902
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Country | US
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Telephone | 573-333-0084
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JARRED YATES
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Credential |
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Telephone | 573-333-0084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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