NPIMap

Organization Active NPI

Carpenter Host Home

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Douglas, GA
National Provider Identifier
1629535216
Registry record updated Mar 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
CARPENTER HOST HOME
Practice address
806 Grady Ave N
Douglas, GA 31533-4812
Phone
(912) 449-7100
NPI assigned
Mar 1, 2019
Last updated
Mar 1, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
UNISON BEHAVIORAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2019

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

Authorized official

Name
Laura Michelle Simpson
Title
Manager
Phone
(912) 449-7109

Specialties & licenses 1

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

Addresses

Primary practice location

806 Grady Ave N
Douglas, GA 31533-4812

Mailing address

1007 Mary St
Waycross, GA 31503-3823
Phone (912) 449-7111

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": "1551398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551398400000",
    "number": "1629535216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 MARY ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315033823",
            "telephone_number": "912-449-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 GRADY AVE N",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315334812",
            "telephone_number": "912-449-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARPENTER HOST HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNISON BEHAVIORAL HEALTH",
        "enumeration_date": "2019-03-01",
        "last_updated": "2019-03-01",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "912-449-7109"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; 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.