NPIMap

Organization Active NPI

Shirley Davis

  • Assisted Living Facility (Mental Illness)
  • Waycross, GA
National Provider Identifier
1619314432
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 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
Last updated
Jun 3, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
UNISON BEHAVIORAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

1007 Mary St
Waycross, GA 31503-3823

Mailing address

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

National Provider Directory

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

Organizations with this tax ID in the same state 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1619314432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 ALBANY AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315030769",
            "telephone_number": "912-449-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 MARY ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315033823",
            "telephone_number": "912-449-7111",
            "fax_number": "912-449-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIRLEY DAVIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNISON BEHAVIORAL HEALTH",
        "enumeration_date": "2013-06-03",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "912-449-7111"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.