Provider Demographics
NPI:1386890713
Name:WHITE DEER RUN LLC
Entity type:Organization
Organization Name:WHITE DEER RUN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT & SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-861-6000
Mailing Address - Street 1:PO BOX G
Mailing Address - Street 2:BUILDING #13
Mailing Address - City:TORRANCE
Mailing Address - State:PA
Mailing Address - Zip Code:15779-0114
Mailing Address - Country:US
Mailing Address - Phone:724-459-9700
Mailing Address - Fax:
Practice Address - Street 1:OPEN BUILDING NUMBER 13
Practice Address - Street 2:TORRANCE STATE HOSPITAL
Practice Address - City:TORRANCE
Practice Address - State:PA
Practice Address - Zip Code:15779
Practice Address - Country:US
Practice Address - Phone:724-459-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility