Organization · Type 2 NPI

Willie Colquitt Host Home

Intellectual and/or Developmental Disabilities Residential Treatment Facility · Waycross, GA

NPI number 1780126185 Active

Practice location

1007 Mary St
Waycross, GA 31503-3823

Call (912) 449-7109 Map

Fax (912) 449-7056

Mailing address

950 Gus Paulk Rd
Ambrose, GA 31512-3406

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary 320600000XNone listed

Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

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About NPI 1780126185

Willie Colquitt Host Home's National Provider Identifier is 1780126185, issued on Nov 16, 2016. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Waycross, GA. The record was last updated on Nov 16, 2016.