WILLIE DEEANJLO0 WHITE (NPI# 1730576091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730576091 |
| Entity Type | Individual |
| Full Name | WILLIE DEEANJLO0 WHITE |
| Credential | LICDC-CS |
| Practice Address |
1580 State Route 56 Sw London OH 43140-8623 |
| Mailing Address |
770 W Broad St Columbus OH 43222-1419 |
| Practice Telephone | 7408522454 |
| Mailing Telephone | 6147521290 |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2015-04-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013313303 | Willie White Jr. | Counselor | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2014-11-13 |
| 1053572354 | Willie James White Jr. | Counselor | 91 Glendale St, Highland Park, MI 48203-3274 | 2008-06-19 |
| 1366586059 | Willie White | Counselor | 4800 S 10th St, Milwaukee, WI 53221-2412 | 2007-02-16 |
| Street Address |
1580 STATE ROUTE 56 SW |
| City | LONDON |
| State | OH |
| Zip Code | 43140-8623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770893489 | Trina Marie Bottorff | Registered Nurse | 1580 State Route 56 Sw, London, OH 43140-8623 | 2010-10-15 |
| 1437651346 | Veronica Denise Bellamy | Counselor | 1580 State Route 56 Sw, London, OH 43140-8623 | 2018-03-06 |
| 1902218779 | State of Ohio | Community/Behavioral Health | 1580 State Route 56 Sw, London Correctional Institution, London, OH 43140-8623 | 2014-05-28 |
| 1710264569 | Barbara Jean Woods | Internal Medicine | 1580 State Route 56 Sw, London, OH 43140-8623 | 2011-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124588421 | Jennifer Howard | Counselor | 1851 Oh-56, London, OH 43140 | 2019-03-22 |
| 1497251896 | Jessica Nicole Ward | Registered Nurse | 371 Lafayette Street, London, OH 43140 | 2018-04-04 |
| 1356738439 | Kimberly Irene Kohli | Psychologist | 1580 State Route 56, Madison Correctional Institution, London, OH 43140 | 2015-04-16 |
| 1033502463 | Misty Fowler | Licensed Practical Nurse | 3775 Us Highway 40 Sw, London, OH 43140 | 2015-03-10 |
| 1295145266 | Sophie Hall | Licensed Practical Nurse | 2820 Old National Road, London, OH 43140 | 2014-04-30 |
| 1891119509 | London City Schools | Early Intervention Provider Agency | 380 Elm Street, London, OH 43140 | 2014-02-17 |
| 1588087654 | Dona Langdon | Dental Hygienist | 1580 State Roure 56, London, OH 43140 | 2014-01-27 |
| 1073818670 | David Allen Fairchild | Pharmacist | 238 Lafayette Street, K Mart Pharmacy 7547, London, OH 43140 | 2011-01-13 |
| 1275771958 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1355 St. Rt. 38 Se, London, OH 43140 | 2009-02-03 |
| 1225250756 | John C Starr | Hospice Care, Community Based | 62 S Oak St, London, OH 43140 | 2007-05-03 |
| Find all providers in zip 43140 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558849620 | Pinnacle Treatment Centers Ky-1, LLC | Substance Abuse Rehabilitation Facility | 312 Carrera Drive, London, KY 40741 | 2018-08-01 |
| 1710463435 | Pinnacle Treatment Centers Ky-i, LLC | Substance Abuse Rehabilitation Facility | 300 Carrera Drive, London, KY 40741 | 2018-07-16 |
| 1952727505 | Renew Recovery, LLC | Substance Abuse Rehabilitation Facility | 2645 N Laurel Rd Ste B, London, KY 40741 | 2014-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588270128 | Findlay Center for Recovery | Substance Abuse Rehabilitation Facility | 1800 Manor Hill Rd, Findlay, OH 45840-6612 | 2020-09-18 |
| 1093324352 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 7745 Ivygate Lane, Cincinnati, OH 45242 | 2020-07-23 |
| 1467060764 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 7745 Ivygate Ln, Montgomery, OH 45242-5119 | 2020-07-22 |
| 1265040554 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 7172 Pfeiffer Road, Cincinnati, OH 45242 | 2020-07-22 |
| 1144838442 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 10519 Cinderella Drive, Cincinnati, OH 45242 | 2020-07-22 |
| 1114535978 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 4365 Classic Dr, Blue Ash, OH 45241-2205 | 2020-07-17 |
| 1740800077 | Cairn Recovery Resources LLC | Substance Abuse Rehabilitation Facility | 217 Muskingum Ave, Zanesville, OH 43701-4957 | 2020-04-16 |
| 1013543982 | New Life Recovery, LLC | Substance Abuse Rehabilitation Facility | 14761 State Route 93 Unit 4, Jackson, OH 45640-9820 | 2020-03-23 |
| 1104450063 | Quest Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 401 W High St Ste 9, Mount Vernon, OH 43050-2346 | 2020-02-28 |
| 1922638634 | Randall Jay Smith | Substance Abuse Rehabilitation Facility | 1321 S Westwood Dr, Zanesville, OH 43701-5650 | 2020-01-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.