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General NPI Number Information
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NPI Number | 1952303737
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Entity Type | Organization
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Legal Business Name | THE HENRY & RILLA WHITE YOUTH FOUNDATION INC
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 305 NW CHRISTIAN CT
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City | LAKE CITY
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State | FL
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Zip | 32055-4837
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Country | US
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Telephone | 352-752-7813
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Fax | 352-752-7836
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Provider Business Mailing Address
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Address Line | 2833 REMINGTON GREEN CIR
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City | TALLAHASSEE
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State | FL
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Zip | 32308-3752
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Country | US
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Telephone | 850-922-8375
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Fax | 850-488-2071
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Authorized Official
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Title or Position | CEO
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Name | MRS. LINDA DURRANCE
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Credential |
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Telephone | 850-922-8375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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