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General NPI Number Information
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NPI Number | 1932372083
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Entity Type | Organization
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Legal Business Name | WHITE OAKS RESIDENTIAL SERVICES, LLC
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 5908 S NC HIGHWAY 49
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City | BURLINGTON
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State | NC
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Zip | 27215-9621
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Country | US
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Telephone | 336-228-8513
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2182
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City | JAMESTOWN
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State | NC
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Zip | 27282-2182
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | QUENTIN HILL
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Credential |
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Telephone | 336-862-6818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State | NC
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