WHITE OAK MANOR
NPI 1205224128
Skilled Nursing Facility in Warren, OH

Active since December 30, 2014CLIA 36D0723934 · Waiver
1926 RIDGE AVE SE, WARREN, OH 44484(330) 369-4672 Get Directions Write a Review

NPPES record last updated: December 30, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About White Oak Manor NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WHITE OAK MANOR (NPI 1205224128) is a healthcare organization registered as a skilled nursing facility in Warren, Ohio and active in the NPI registry since December 2014. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists William Hetrick, Administrator, as its authorized official.

NPPES Registry Identity

NPI1205224128
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameWHITE OAK MANOR
Location Address1926 RIDGE AVE SEWarren, OH 44484-2821
Mailing Address1926 Ridge Ave SeWarren, OH 44484-2821
Organization SubpartNo
Authorized OfficialWilliam HetrickAdministrator · (330) 369-4672
Enumeration DateDecember 30, 2014
NPI 1205224128 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
1926 RIDGE AVE SE, Warren, OH 44484

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D0723934

White Oak · Warren, OH
Active · expires Aug 31, 2026
CLIA Number36D0723934
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRichard W. Hartline
Laboratory Phone(330) 369-4672
Laboratory LocationWhite Oak1926 Ridge Road, Warren, OH 44484
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
1926 RIDGE AVE SE
WARREN, OH 44484
Physical Therapy Assistant
1926 RIDGE AVE SE
WARREN, OH 44484
Community Health Worker
1926 RIDGE AVE SE
WARREN, OH 44484
Skilled Nursing Facility
1926 RIDGE AVE SE
WARREN, OH 44484
Occupational Therapy Assistant
1926 RIDGE AVE SE
WARREN, OH 44484
Skilled Nursing Facility
1926 RIDGE AVE SE
WARREN, OH 44484
Community Health Worker
1926 RIDGE AVE SE
WARREN, OH 44484

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is White Oak Manor's NPI number?

The NPI number for White Oak Manor is 1205224128. It was assigned to this organization in the NPPES registry on December 30, 2014.

Where is White Oak Manor located?

White Oak Manor is located at 1926 Ridge Ave SE, Warren, OH 44484. The listed phone number is (330) 369-4672.

What is White Oak Manor's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does White Oak Manor hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D0723934) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for White Oak Manor was last updated on December 30, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.