Dailey/spell Host Home

NPI #1396121778 in Waycross, Georgia

Provider Information

NPI Number: 1396121778
Entity Type: Organization
Organization Name: Dailey/spell Host Home
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Aug 7, 2015
Last Updated: Aug 7, 2015

Practice Location

Address: 1007 MARY ST
City: Waycross
State: Georgia
ZIP Code: 31503-3823
Phone: (912) 449-7109

Authorized Official

Name: MICHELLE SIMPSON
Title: BILLING MANAGER
Phone: (912) 449-7109

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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