Provider Demographics
NPI:1427725969
Name:HENRY AND RILLA WHITE YOUTH FOUNDATION, INC.
Entity type:Organization
Organization Name:HENRY AND RILLA WHITE YOUTH FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DURRANCE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:850-922-8375
Mailing Address - Street 1:2833 REMINGTON GREEN CIR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-3752
Mailing Address - Country:US
Mailing Address - Phone:185-092-2837
Mailing Address - Fax:
Practice Address - Street 1:305 NW CHRISTIAN CT
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-4837
Practice Address - Country:US
Practice Address - Phone:185-092-2837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech