Southwestern State Hospital

NPI #1518049675 in Thomasville, Georgia

Provider Information

NPI Number
1518049675
Entity Type
Organization
Organization Name
Southwestern State Hospital
Primary Specialty
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date
Oct 19, 2006
Last Updated
Aug 18, 2009

Practice Location

Address
130 COVE LANDING DR
Address 2
COMMUNITY MEDICAID WAIVER HOME
State
Georgia
ZIP Code
31792-3883
Phone
(229) 227-2977

Authorized Official

Name
MRS. HILARY J. HOO-YOU
Title
REGIONAL HOSPITAL ADMINISTRATOR
Phone
(229) 227-3021

Specialties & Taxonomy Codes

Specialty
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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