Unison Behavioral Health
Organization Active NPI Community/Behavioral Health Agency · Waycross, GA
NPI 1902943046 · NPPES record last updated Jul 25, 2013
Key facts
- NPI
- 1902943046
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- UNISON BEHAVIORAL HEALTH
- Practice address
- 310 Williams Street
Waycross, GA 31503 - Phone
- (912) 449-7100
- Fax
- (912) 449-7056
- NPI assigned
- Jan 30, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Allen Brown
- Title
- Ceo
- Phone
- (912) 449-7100
Other NPIs on the same Medicare enrollment 10
Corporate family (same tax ID) 20
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040220000112 | GA | Part B Supplier - Clinic/Group Practice | 7517852247 |
Receives reassigned benefits from 33 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Waycross, GA; Nahunta, GA; Folkston, GA; Homerville, GA; Alma, GA; Douglas, GA |
National Provider Directory
- Tax ID family
- Supportive Employment
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
310 Williams Street
Waycross, GA 31503
Mailing address
1007 Mary Street
Waycross, GA 31503
Phone (912) 449-7100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000606295AA | Medicaid | GA |
Other names
- Satilla Community Services
Other providers in Waycross, GA
- Unison Behavioral Health
- Unison Behavioral Health
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- Victor Hugo Urbieta Caceres
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All providers in Waycross, GA · Community/Behavioral Health Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.