Provider Demographics
NPI:1740499110
Name:THE WHITE HOUSE
Entity type:Organization
Organization Name:THE WHITE HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BHAGWAN
Authorized Official - Middle Name:HIRANAND
Authorized Official - Last Name:ADVANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-284-1940
Mailing Address - Street 1:452 STATE ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-4621
Mailing Address - Country:US
Mailing Address - Phone:912-283-2000
Mailing Address - Fax:912-285-3080
Practice Address - Street 1:452 STATE ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-4621
Practice Address - Country:US
Practice Address - Phone:912-283-2000
Practice Address - Fax:912-285-3080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility