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WILLIE COLQUITT HOST HOME
NPI 1780126185
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Waycross, GA

Active since November 16, 2016
1007 MARY ST, WAYCROSS, GA 31503(912) 449-7109(912) 449-7056 Get Directions Write a Review

NPPES record last updated: November 16, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Willie Colquitt Host Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLIE COLQUITT HOST HOME (NPI 1780126185) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Waycross, Georgia and active in the NPI registry since November 2016. The organization lists Michelle Simpson, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1780126185
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameWILLIE COLQUITT HOST HOME
Location Address1007 MARY STWaycross, GA 31503-3823
Mailing Address950 Gus Paulk RdAmbrose, GA 31512-3406 · (912) 501-7354 · Fax (912) 449-7056
Phone(912) 449-7109
Fax(912) 449-7056
Organization SubpartNo
Authorized OfficialMichelle SimpsonBilling Manager · (912) 449-7109
Enumeration DateNovember 16, 2016
✔ NPI 1780126185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
Definition
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.
1007 MARY ST, Waycross, GA 31503
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISTY BURCHETTE
Counselor
1007 MARY ST
WAYCROSS, GA 31503
Ware County (912) 449-7100
MELINDA ROZIER RN
Registered Nurse (Addiction (Substance Use Disorder))
1007 MARY ST
WAYCROSS, GA 31503
Ware County (912) 449-8600
JACQUELINE DUNNOM LPN
Licensed Practical Nurse
1007 MARY ST
WAYCROSS, GA 31503
Ware County (912) 449-8601
NATASHA WILLIAMS HERRIN LSCSW
Social Worker (Clinical)
1007 MARY ST
WAYCROSS, GA 31503
Ware County (912) 449-7100
CHARLES E PRITCHETT LAPC
Counselor (Mental Health)
1007 MARY ST
WAYCROSS, GA 31503
Ware County (912) 449-7100
ROBIN KAY DENISON LPN
Licensed Practical Nurse
1007 MARY ST
WAYCROSS, GA 31503
Ware County (912) 449-8601
MARSHA KRIETE LPN
Licensed Practical Nurse
1007 MARY ST
WAYCROSS, GA 31503
Ware County (912) 449-8600
SONYA LEE RN
Registered Nurse (Addiction (Substance Use Disorder))
1007 MARY ST
WAYCROSS, GA 31503
Ware County (912) 449-8600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willie Colquitt Host Home's NPI number?

The NPI number for Willie Colquitt Host Home is 1780126185. It was assigned to this organization in the NPPES registry on November 16, 2016.

Where is Willie Colquitt Host Home located?

Willie Colquitt Host Home is located at 1007 Mary St, Waycross, GA 31503. The listed phone number is (912) 449-7109.

What is Willie Colquitt Host Home's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for Willie Colquitt Host Home was last updated on November 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.