White Family Care Home

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

6905109 Issued in FL

Legal business name

WHITE FAMILY CARE HOME

Practice address

4859 Publix Road
Oviedo, FL 32765

Phone

(407) 365-9110

Fax

(407) 542-7301

NPI assigned

Sep 4, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Ethel White, NURSE

Title

Owner/ Operator

Phone

(407) 365-9110

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346716800000",
    "number": "1770832941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4859 PUBLIX ROAD",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "32765",
            "telephone_number": "407-365-9110",
            "fax_number": "407-542-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4859 PUBLIX ROAD",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "32765",
            "telephone_number": "407-365-9110",
            "fax_number": "407-542-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-04",
        "last_updated": "2012-09-04",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "ETHEL",
        "authorized_official_title_or_position": "OWNER/ OPERATOR",
        "authorized_official_telephone_number": "407-365-9110",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NURSE"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "6905109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141522100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Reine Welch, PTA
• Erik Wenzel
• Lori West
• Lisa Ann Wharton
• Kaitlyn Elizabeth Whitcomb, PHD
• Ana White, COTA
• Erin Wiseman White, PA
• Rebecca Anne Whiteman, CCC-SLP
• Amy Whitford
• Emily Whitsett

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Oviedo, FL
• Providers in Oviedo, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.