SHIRLEY DAVIS (NPI# 1619314432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619314432 |
| Entity Type | Organization |
| Organization Name | SHIRLEY DAVIS |
| Practice Address |
1007 Mary St Waycross GA 31503-3823 |
| Mailing Address |
3675 Albany Ave Waycross GA 31503-0769 |
| Practice Telephone | 9124497111 |
| Practice Fax Number | 9124497060 |
| Mailing Telephone | 9124497100 |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2013-06-03 |
| Authorized Official Name | WENDY HUGHES (CFO) |
| Authorized Official Telephone | 9124497111 |
| Is Organization Subpart | Y |
| Parent Organization Name | UNISON BEHAVIORAL HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities |
| Street Address |
1007 MARY ST |
| City | WAYCROSS |
| State | GA |
| Zip Code | 31503-3823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972649374 | Janett Carter | Social Worker | 1007 Mary St, Waycross, GA 31503-3823 | 2007-01-30 |
| 1417412917 | Jessica Kate Clark | Nurse Practitioner | 1007 Mary St, Waycross, GA 31503-3823 | 2019-02-08 |
| 1093299356 | Natasha Williams Herrin | Social Worker | 1007 Mary St, Waycross, GA 31503-3823 | 2018-09-21 |
| 1063996619 | Jonathon Michael Pryor | Counselor | 1007 Mary St, Waycross, GA 31503-3823 | 2018-09-19 |
| 1780188805 | Alisha Lester | Counselor | 1007 Mary St, Waycross, GA 31503-3823 | 2018-03-22 |
| 1487158507 | Sonda Sperzel | Counselor | 1007 Mary St, Waycross, GA 31503-3823 | 2018-03-22 |
| 1508375932 | Karen Manac | Social Worker | 1007 Mary St, Waycross, GA 31503-3823 | 2017-09-28 |
| 1487185492 | Donnel Cross Host Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1007 Mary St, Waycross, GA 31503-3823 | 2017-03-22 |
| 1780126185 | Willie Colquitt Host Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1007 Mary St, Waycross, GA 31503-3823 | 2016-11-16 |
| 1669922332 | Altomese Neloms Host Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1007 Mary St, Waycross, GA 31503-3823 | 2016-10-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770855868 | Bertha Richardsaon | Community/Behavioral Health | 1614 Carswell Ave, Waycross, GA 31503 | 2012-02-03 |
| 1134365893 | Carla Pye Winn | Nurse Practitioner | 1003 Mary St, Waycross, GA 31503 | 2008-12-31 |
| 1801051297 | Unison Behavioral Health | Substance Abuse Rehabilitation Facility | 3455 Harris Road, Waycross, GA 31503 | 2008-07-24 |
| 1073650115 | Unison Behavioral Health | Community/Behavioral Health | 1003 Mary Street, Waycross, GA 31503 | 2007-01-30 |
| 1588701635 | Unison Behavioral Health | Community/Behavioral Health | 2033 Bell Street, Waycross, GA 31503 | 2007-01-30 |
| 1801933957 | Unison Behavioral Health | Day Training, Developmentally Disabled Services | 3201 Harris Road, Waycross, GA 31503 | 2007-01-30 |
| 1902943046 | Unison Behavioral Health | Community/Behavioral Health | 310 Williams Street, Waycross, GA 31503 | 2007-01-30 |
| 1285770578 | Unison Behavioral Health | Community/Behavioral Health | 305 N Nicholls Street, Waycross, GA 31503 | 2007-01-30 |
| 1538223672 | Diversified Resources, Inc. | Case Manager/Care Coordinator | 147 Knight Ave Cir, Waycross, GA 31503 | 2006-12-21 |
| 1669578167 | James Gregory Morris | Dentist | 2458 Memorial Drive, Waycross, GA 31503 | 2006-09-15 |
| Find all providers in zip 31503 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215842 | Stewart Community Home, Inc. | Assisted Living Facility | 1125 15th St, Columbus, GA 31901-2219 | 2020-11-06 |
| 1952851602 | Gates Health Care Services, LLC | Assisted Living Facility | 400 Wallace Cir, Bloomingdale, GA 31302-8050 | 2016-10-06 |
| 1801251202 | Prime Veritas | Assisted Living Facility | 1889 Trinity Mill Dr, Dacula, GA 30019-1015 | 2015-12-30 |
| 1053730267 | Hooks Home of Care | Assisted Living Facility | 4466 Pinedale Dr, Macon, GA 31206-4530 | 2014-04-15 |
| 1699024141 | Transitional Hope Unlimited | Assisted Living Facility | 4 Harvey St Ne, Rome, GA 30161-5122 | 2012-08-30 |
| 1164782223 | Sweet Pea Personal Care Home | Assisted Living Facility | 9387 Burkhalter Rd, Statesboro, GA 30461-6765 | 2012-05-23 |
| 1447532007 | Pendley Personal Care Home Inc. | Assisted Living Facility | 2548 Central Ave, Augusta, GA 30904-6240 | 2011-09-09 |
| 1215216445 | Paula's Safe House | Assisted Living Facility | 3900 Rockey Valley Dr, Conley, GA 30288-1410 | 2011-08-04 |
| 1174819619 | Prn Nursing and Alternative Living Family Care Solutions | Assisted Living Facility | 115 Lakeshore Dr S, Ivey, GA 31031-3537 | 2011-06-23 |
| 1477859841 | Fairview Community Personal Care Home, Inc. | Assisted Living Facility | 2470 Fairview Rd Se, Conyers, GA 30013-4919 | 2011-02-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.