SOUTHWESTERN STATE HOSPITAL (NPI# 1285627448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285627448 |
| Entity Type | Organization |
| Organization Name | SOUTHWESTERN STATE HOSPITAL |
| Practice Address |
210 Loomis Street Integration Home Thomasville GA 31792 |
| Mailing Address |
Po Box 1378 Patient Billing Dept Thomasville GA 31799-1378 |
| Practice Telephone | 2292273004 |
| Practice Fax Number | 2272272663 |
| Mailing Telephone | 2292273004 |
| Mailing Fax Number | 2292272663 |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2009-08-18 |
| Authorized Official Name | MRS. HILARY J HOO-YOU (REGIONAL HOSPITAL ADMINISTRATOR) |
| Authorized Official Telephone | 2292273021 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 136-01-092-8 | GA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 647660886A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548407364 | Southwestern State Hospital | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 419 N Crawford St, Community Medicaid Comp Waiver Home, Thomasville, GA 31792-5128 | 2009-01-15 |
| 1326285248 | Southwestern State Hospital | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 845 Crabapple Dr, Community Medicaid Comp Homes, Thomasville, GA 31757-1400 | 2009-01-14 |
| 1497992457 | Southwestern State Hospital | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 309a Shoreline Dr, Community Medicaid Comp Waiver Home, Thomasville, GA 31757-2577 | 2009-01-13 |
| 1841320280 | Southwestern State Hospital | Substance Abuse Rehabilitation Facility | 1500 Gillionville Rd Ste B, Albany, GA 31707-3963 | 2007-03-06 |
| 1619045291 | Southwestern State Hospital | Community/Behavioral Health | 819 Tillman St, Patient Billing Dept, Hahira, GA 31632-1451 | 2006-12-01 |
| 1366519811 | Southwestern State Hospital | Community/Behavioral Health | 200 W Oglethorpe Blvd Fl 4, Patient Billing Dept, Albany, GA 31701-6802 | 2006-11-29 |
| 1871675934 | Southwestern State Hospital | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8 Belmont Dr, Community Medicaid Waiver Home Chss, Thomasville, GA 31792-4725 | 2006-10-19 |
| 1851473912 | Southwestern State Hospital | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 114 Cove Landing Dr, Community Medicaid Waiver Home Rts, Thomasville, GA 31792-3883 | 2006-10-19 |
| 1881776946 | Southwestern State Hospital | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Cove Landing Dr, Community Medicaid Waiver Home Mrwp, Thomasville, GA 31792-3883 | 2006-10-19 |
| 1376645796 | Southwestern State Hospital | Community Based Residential Treatment Facility, Mental Illness | 307 Cloverdale Dr, Intensive Treatment Residence Program, Thomasville, GA 31792-4018 | 2006-09-05 |
| Street Address |
210 LOOMIS STREET INTEGRATION HOME |
| City | THOMASVILLE |
| State | GA |
| Zip Code | 31792 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739879 | Georgia Pines Community Service Board | Community/Behavioral Health | 407 Cloverdale Drive, Thomasville, GA 31792 | 2018-02-09 |
| 1932613551 | Diana Diaz | Physician Assistant | 2705 E Pinetree Blvd Ste A, Thomasville, GA 31792 | 2017-11-17 |
| 1194249425 | Bobbie Frazier | Contractor | 400 Cloverdale Dr, Thomasville, GA 31792 | 2017-07-28 |
| 1598132292 | Southern Scripts, LLC | Pharmacy | 501 Gordon Avenue, Thomasville, GA 31792 | 2015-08-28 |
| 1508248915 | Elizabeth Nicole Keen | Behavioral Analyst | 121 Covington Ave Apt 9, Thomasville, GA 31792 | 2015-06-22 |
| 1417341579 | Sheila L Stanley | Counselor | 301 Summercreek Cove, Thomasville, GA 31792 | 2015-03-26 |
| 1457749301 | Ashley Lamb | Speech-Language Pathologist | 1203 East Jackson Street, Thomasville, GA 31792 | 2014-12-30 |
| 1831403880 | Somnoquest | Durable Medical Equipment & Medical Supplies | 556 Hall Road, Thomasville, GA 31792 | 2010-08-02 |
| 1508000183 | Kashyap B Choksi | Internal Medicine | 100 Mimosa Drive 2nd Floor, Thomasville, GA 31792 | 2009-04-27 |
| 1205008786 | Mark J Glaccum | Chiropractor | 415 Gordon Avenue, Thomasville, GA 31792 | 2008-03-25 |
| Find all providers in zip 31792 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417258732 | Atlemisia Anderson | Community Based Residential Treatment Facility, Mental Illness | 416 Glen Arven Dr, Thomasville, GA 31792-6837 | 2010-11-03 |
| 1902946411 | Baptist Children's Homes of North Carolina, Inc. | Community Based Residential Treatment Facility, Mental Illness | 515 Watson Ave, Thomasville, NC 27360-4540 | 2007-02-07 |
| 1871642132 | Faith and Hope House | Community Based Residential Treatment Facility, Mental Illness | 402 Crestview Dr, Thomasville, NC 27360-3206 | 2007-01-09 |
| 1376645796 | Southwestern State Hospital | Community Based Residential Treatment Facility, Mental Illness | 307 Cloverdale Dr, Intensive Treatment Residence Program, Thomasville, GA 31792-4018 | 2006-09-05 |
| 1912009341 | Southwestern State Hospital | Community Based Residential Treatment Facility, Mental Illness | 105 Bermuda Street, Patient Billing Dept., Thomasville, GA 31792-4018 | 2006-09-05 |
| 1023671039 | Macs Village LLC | Community Based Residential Treatment Facility, Mental Illness | 205 Princeton Xing, Thomasville, NC 27360-9218 | 2019-04-16 |
| 1730172982 | Southwestern State Hospital | Community Based Residential Treatment Facility, Mental Illness | 400 S Pinetree Blvd, Crisis Stabilization Program, Thomasville, GA 31792-7128 | 2005-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417561747 | Georgia Regional Health LLC | Community Based Residential Treatment Facility, Mental Illness | 1211 Waterville Ct, Alpharetta, GA 30022-5381 | 2020-09-03 |
| 1275161192 | Monte Nido Georgia LLC | Community Based Residential Treatment Facility, Mental Illness | 124 Johnson Ferry Rd Ne, Sandy Springs, GA 30328-3004 | 2020-03-27 |
| 1811464035 | Hope Homes Recovery, LLC | Community Based Residential Treatment Facility, Mental Illness | 432 Virginia Rd, Atlanta, GA 30338-4793 | 2018-10-25 |
| 1770066029 | New Beginnings PCh of Columbus, LLC | Community Based Residential Treatment Facility, Mental Illness | 639 Lawyers Ln, Columbus, GA 31906-3812 | 2018-09-12 |
| 1588140859 | Butterfly Development, LLC | Community Based Residential Treatment Facility, Mental Illness | 1911 Grayson Highway, Suite 8-242, Grayson, GA 30017 | 2018-07-19 |
| 1326555210 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 101, Riverdale, GA 30274-1502 | 2018-01-02 |
| 1245747138 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 104, Riverdale, GA 30274-1502 | 2018-01-02 |
| 1235646217 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 401, Riverdale, GA 30274-1502 | 2017-12-29 |
| 1528574431 | House of Concrete Roses, LLC | Community Based Residential Treatment Facility, Mental Illness | 1133 Huff Rd Nw Apt 766, Atlanta, GA 30318-4327 | 2017-12-15 |
| 1508391756 | Mister Life Coach | Community Based Residential Treatment Facility, Mental Illness | 3681 N Decatur Rd Apt R11, Decatur, GA 30032-1062 | 2017-04-25 |
| Find all providers with the same taxonomy | ||||
| City | THOMASVILLE |
| Zip Code | 31792 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.