MEDICARE: WHITE DEER RUN, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	00257052	PA
2	251S00000X	Community/Behavioral Health Agency	00257052	PA
3	261Q00000X	Clinic/Center	257052	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952421968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITE DEER RUN, INC

Provider Business Mailing Address
First Line	:	4020 ASPEN GROVE DR STE 900
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-3134
Country	:	US
Telephone Number	:	615-861-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1921 W 8TH ST
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16505-4936
Country	:	US
Telephone Number	:	814-452-2291
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT & SECRETARY
Name	:	BRIAN P. FARLEY
Credential	:
Telephone Number	:	615-861-6000

Provider Enumeration Date	:	03/31/2007
Last Update Date	:	01/20/2026

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Directions to “WHITE DEER RUN, INC ” Practice Location

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