Provider Demographics
NPI:1275579641
Name:WHITE OAK HOMES II, INC.
Entity Type:Organization
Organization Name:WHITE OAK HOMES II, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:B
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-658-5598
Mailing Address - Street 1:231 NW CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:NC
Mailing Address - Zip Code:28365-1719
Mailing Address - Country:US
Mailing Address - Phone:919-658-5598
Mailing Address - Fax:919-658-0305
Practice Address - Street 1:231 NW CENTER ST
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:NC
Practice Address - Zip Code:28365-1719
Practice Address - Country:US
Practice Address - Phone:919-658-5598
Practice Address - Fax:919-658-0305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCMHL-031-051Medicaid
NCMHL-096-035Medicaid
NCMHL-096-142Medicaid
NCMHL-096-094Medicaid
NCMHL-031-024Medicaid
NCMHL-054-086Medicaid
NCMHL-082-019Medicaid
NCMHL-096-063Medicaid
NCMHL-096-066Medicaid
NCMHL-096-190Medicaid
NCMHL-031-046Medicaid
NCMHL-031-043Medicaid
NCMHL-096-032Medicaid
NCMHL-096-144Medicaid
NCMHL-096-158Medicaid
NCMHL.031-057Medicaid