NPI 1629535216
Carpenter Host Home
Practice location
- Address
- 806 Grady Ave N, Douglas, GA 31533-4812
- Phone
- (912) 449-7100
- Mailing address
- 1007 Mary St, Waycross, GA 31503-3823
Authorised official
- Name
- Laura Michelle Simpson
- Title
- Manager
- Phone
- (912) 449-7109
Registered specialties
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1629535216
- Entity type
- Organization
- NPI issued
- 1 Mar 2019
- Record last updated
- 1 Mar 2019
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.