Provider Demographics
NPI:1508058850
Name:WHITE PLAINS CHILDREN'S CENTER
Entity Type:Organization
Organization Name:WHITE PLAINS CHILDREN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-469-2217
Mailing Address - Street 1:313 SE MAYNARD RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4511
Mailing Address - Country:US
Mailing Address - Phone:919-469-2217
Mailing Address - Fax:919-469-0377
Practice Address - Street 1:313 SE MAYNARD RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4511
Practice Address - Country:US
Practice Address - Phone:919-469-2217
Practice Address - Fax:919-469-0377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300100KMedicaid
NC8300100Medicaid