# WHITE RIVER HOME HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619301116
- **Authorized official:** CHRISTOPHER W JOHNSON (MANAGING MEMBER)
- **Authorized official phone:** (662) 322-0506

## Contact information

- **Practice address:** 2100 EAST WASHINGTON STREET STE D, IDABEL, OK 74745
- **Practice address phone:** (580) 286-2664
- **Practice address fax:** (580) 286-2929
- **Mailing address:** PO BOX 299, IDABEL, OK 74745-0299
- **Mailing address phone:** (580) 286-2664
- **Mailing address fax:** (580) 286-2929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | OK | Yes |

## Other

- **Enumeration date:** 09/03/2013
- **Last updated:** 09/03/2013