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Willie Deeanjlo0 White, LICDC-CS
Substance Abuse Rehabilitation Facility in London, Ohio
NPI 1730576091

Willie Deeanjlo0 White is a Substance Abuse Rehabilitation Facility based in Columbus, OH. Willie Deeanjlo0 White practices in London, OH and has the professional credentials of LICDC-CS. The NPI Number for Willie Deeanjlo0 White is 1730576091 and holds a License No. (Ohio).

The current practice location address for Willie Deeanjlo0 White is 1580 State Route 56 Sw, London, OH and can be reached out via phone at 740-852-2454.

Location: 1580 State Route 56 Sw, London, OH, 43222-1419
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730576091
Provider Name
Willie Deeanjlo0 White
Credential
LICDC-CS
Provider Entity Type
Individual
Gender
Male
Address
1580 State Route 56 Sw, London, OH, 43222-1419
Phone Number
740-852-2454
Fax Number
Provider Enumeration Date
04/23/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1580 State Route 56 Sw
City
London
State
Ohio
Zip
43140-8623
Phone Number
740-852-2454
Fax Number
person
Provider Business Mailing Address Details
Address
1580 State Route 56 Sw
City
London
State
Ohio
Zip
43140-8623
Phone Number
740-852-2454
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
()
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
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