Shirley Davis

Organization Active NPI Assisted Living Facility (Mental Illness) · Waycross, GA

NPI 1619314432 · NPPES record last updated Jun 3, 2013

Key facts

NPI
1619314432
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility (Mental Illness) 3104A0625X
Legal business name
SHIRLEY DAVIS
Practice address
1007 Mary St
Waycross, GA 31503-3823
Phone
(912) 449-7111
Fax
(912) 449-7060
NPI assigned
Jun 3, 2013
Organization subpart
Yes
Parent organization (as reported)
UNISON BEHAVIORAL HEALTH

Authorized official

Name
Wendy Hughes
Title
Cfo
Phone
(912) 449-7111

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Supportive Employment (71 organizations share this tax ID)
Part of
Supportive Employment

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X Yes

Addresses

Primary practice location

1007 Mary St
Waycross, GA 31503-3823

Mailing address

3675 Albany Ave
Waycross, GA 31503-0769
Phone (912) 449-7100

Other providers in Waycross, GA

All providers in Waycross, GA · Assisted Living Facility (Mental Illness) in Georgia

Sources for this page

Verify at the official NPI Registry.