PAM WHEELER HOST HOME (NPI# 1801231907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801231907 |
| Entity Type | Organization |
| Organization Name | PAM WHEELER HOST HOME |
| Practice Address |
1007 Mary St Waycross GA 31503-3823 |
| Mailing Address |
517 Cartertown Rd Alma GA 31510-4702 |
| Practice Telephone | 9124497111 |
| Practice Fax Number | 9124497060 |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2013-05-02 |
| Authorized Official Name | WENDY HUGHES (CFO) |
| Authorized Official Telephone | 9124497111 |
| Is Organization Subpart | Y |
| Parent Organization Name | SATILLA COMMUNITY SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment 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 |
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| 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 | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346731833 | Charles Hall Host Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1107 Carswell Ave, Waycross, GA 31503-4854 | 2018-05-21 |
| 1548696735 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1007 Mary St, Waycross, GA 31503-3823 | 2013-09-19 |
| 1992131189 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1007 Mary St, Waycross, GA 31503-3823 | 2013-09-19 |
| 1639495682 | Bobby Bennett Host Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1007 Mary St, Waycross, GA 31503-3823 | 2010-04-15 |
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|---|---|---|---|---|
| 1790385862 | Hickory Log Vocational School Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3680 Highway 411 Ne, White, GA 30184-2427 | 2020-10-28 |
| 1801403050 | Safe Haven Personal Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10875 Abercorn St Apt 132, Savannah, GA 31419-1843 | 2020-09-30 |
| 1659987931 | Pinkies Place | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 216 Self St, Warner Robins, GA 31088-5506 | 2020-09-22 |
| 1629680293 | Caregiver Ga, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3736 Executive Center Dr Ste B, Augusta, GA 30907-2360 | 2020-08-17 |
| 1730799073 | Victory Won Counseling and Res Care Prof. Corp | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5014 Snapfinger Woods Dr, Decatur, GA 30035-4003 | 2020-08-02 |
| 1811528649 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 North Street, Douglas, GA 31533 | 2020-01-30 |
| 1619519709 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 516 Freedom Trl, Brunswick, GA 31525-4712 | 2019-10-10 |
| 1215581756 | Elegant Lm Management, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1020 Meadowsong Circle, Lawrenceville, GA 30043 | 2019-08-01 |
| 1467013821 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5101 Parnell Way, Martinez, GA 30907-8896 | 2019-06-26 |
| 1013474915 | Community Service Board of East Central Georgia | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1715 Lawerence Rd, Hephzibah, GA 30815-4445 | 2019-02-27 |
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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.