WILLIE DEEANJLO0 WHITE LICDC-CS NPI 1730576091

NPI Information

Willie Deeanjlo0 White, LICDC-CS is a substance abuse rehabilitation facility in London, OH. The provider is 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. Willie Deeanjlo0 White, LICDC-CS NPI is 1730576091. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1580 STATE ROUTE 56 SW
LONDON, OH
ZIP 43140-623
Phone: (740) 852-2454

The enumeration date for this NPI number is 4/23/2015 and was last updated on 4/27/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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