# WHITE OAK MANOR-WAXHAW INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WHITE OAK MANOR INC
- **Other names:** White Oak of Waxhaw
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124342241
- **Legal business name:** WHITE OAK MANOR INC
- **Authorized official:** MR. DAVID JOE HANEY (VICE PRESIDENT OF FINANCE)
- **Authorized official phone:** (864) 327-1162

## Contact information

- **Practice address:** 700 HOWIE MINE RD, WAXHAW, NC 28173-9715
- **Practice address phone:** (704) 243-7640
- **Practice address fax:** (704) 243-7641
- **Mailing address:** 700 HOWIE MINE RD, WAXHAW, NC 28173-9715
- **Mailing address phone:** (704) 243-7640
- **Mailing address fax:** (704) 243-7641

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0628 | NC | Yes |

## Other

- **Enumeration date:** 03/18/2010
- **Last updated:** 07/01/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 34-5550 | MEDICARE | NC |
| 05 | — | 3405550 | — | NC |