Organization
WHITE OAK MANOR INC
Active
Other names
White Oak Estates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JOE HANEY (VP FINANCE)
(864) 327-1162
Entity
Organization
Contact information
Practice address
400 WEBBER RD, SPARTANBURG, SC 29307-2400
(864) 579-7004
(864) 579-7714
Mailing address
PO BOX 3347, SPARTANBURG, SC 29304-3347
(864) 579-7004
(864) 579-7714
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCF-888
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0466NH
—
SC
01
—
5246670001
NSC MEDICARE ID-PTAN
SC
Enumeration date
02/22/2007
Last updated
11/05/2008
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