Organization
WHITE OAK MANOR CHARLOTTE INC
Active
Parent organization
WHITE OAK MANOR INC
Other names
White Oak Manor Charlotte
Organization subpart
Yes
Provider details
NPI number
Legal business name
WHITE OAK MANOR INC
Authorized official
MR. DAVID JOE HANEY (VP FINANCE)
(864) 327-1162
Entity
Organization
Contact information
Practice address
4009 CRAIG AVE, CHARLOTTE, NC 28211-2505
(704) 365-2620
(704) 365-2624
Mailing address
4009 CRAIG AVE, CHARLOTTE, NC 28211-2505
(704) 365-2620
(704) 365-2624
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0350
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3415238
—
NC
05
—
3416283
—
NC
Enumeration date
02/22/2007
Last updated
11/19/2007
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