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Organization

CHARLES HALL HOST HOME

Active
Parent organization
UNISON BEHAVIORAL HEALTH
Organization subpart
Yes

Provider details

NPI number
Legal business name
UNISON BEHAVIORAL HEALTH
Authorized official
LAURA MICHELLE SIMPSON (BILLING MANAGER)
(912) 449-7109
Entity
Organization

Contact information

Practice address
1107 CARSWELL AVE, WAYCROSS, GA 31503-4854
(912) 449-7109
Mailing address
1007 MARY ST, WAYCROSS, GA 31503-3823

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
05/21/2018
Last updated
05/21/2018
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