NPIMap

Organization Active NPI

Unison Behavioral Health

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Blackshear, GA
National Provider Identifier
1114064409
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
UNISON BEHAVIORAL HEALTH
Practice address
740 Porter Street
Blackshear, GA 31516
Phone
(912) 449-8550
Fax
(912) 449-7056
NPI assigned
Jan 30, 2007
Last updated
Jul 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Authorized official

Name
Mr. Allen Brown
Title
Ceo
Phone
(912) 449-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

740 Porter Street
Blackshear, GA 31516

Mailing address

1007 Mary Street
Waycross, GA 31503
Phone (912) 449-7100

Other identifiers 1

IdentifierTypeStateIssuer
000866016AMedicaidGA

Other names 1

  • Satilla Community Services Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Ernestine Nelson71 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

740 Porter St
Blackshear, GA 31516
Phone (912) 449-8550

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1114064409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 MARY STREET",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "31503",
            "telephone_number": "912-449-7100",
            "fax_number": "912-449-7056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 PORTER STREET",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "31516",
            "telephone_number": "912-449-8550",
            "fax_number": "912-449-7056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNISON BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2013-07-25",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-449-7100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000866016A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Satilla Community Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Blackshear, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.