# DONNEL CROSS HOST HOME

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** UNISON BEHAVIORAL HEALTH
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1487185492
- **Legal business name:** UNISON BEHAVIORAL HEALTH
- **Authorized official:** GLYN THOMAS PHD (CEO)
- **Authorized official phone:** (912) 449-7100

## Contact information

- **Practice address:** 1007 MARY ST, WAYCROSS, GA 31503-3823
- **Practice address phone:** (912) 449-7100
- **Practice address fax:** (912) 449-7063
- **Mailing address:** 408 MACKENZIE CIR, DOUGLAS, GA 31533-1319
- **Mailing address phone:** (912) 331-5816

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/22/2017
- **Last updated:** 03/22/2017