SOUTHWESTERN STATE HOSPITAL (NPI# 1366519811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366519811 |
| Entity Type | Organization |
| Organization Name | SOUTHWESTERN STATE HOSPITAL |
| Other Organization Name | ASSERTIVE COMMUNITY TREATMENT PROGRAM |
| Practice Address |
200 W Oglethorpe Blvd Fl 4 Patient Billing Dept Albany GA 31701-6802 |
| Mailing Address |
Po Box 1378 Patient Billing Department Thomasville GA 31799-1378 |
| Practice Telephone | 2292272977 |
| Practice Fax Number | 2292272955 |
| Mailing Telephone | 2292272977 |
| Mailing Fax Number | 2292272955 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2009-08-18 |
| Authorized Official Name | MRS. HILARY J HOO-YOU (HOSPITAL ADMINISTRATOR) |
| Authorized Official Telephone | 2292273020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 581130678 | GA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00877236E | 05 |
| Other Name | Type Code |
|---|---|
| Assertive Community Treatment Program | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1912009341 | Southwestern State Hospital | Community Based Residential Treatment Facility, Mental Illness | 105 Bermuda Street, Patient Billing Dept., Thomasville, GA 31792-4018 | 2006-09-05 |
| Street Address |
200 W OGLETHORPE BLVD FL 4 PATIENT BILLING DEPT |
| City | ALBANY |
| State | GA |
| Zip Code | 31701-6802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124678347 | Carehere LLC | Family Medicine | Carehere Clinic- City of Albany, Ga, 2000 North Monroe Street, Albany, GA 31701 | 2019-09-19 |
| 1801450788 | Amy Brock | Nurse Practitioner | 417 4th Avenue, Albany, GA 31701 | 2019-04-26 |
| 1346740131 | Kawana Kesia Mullins | Contractor | 1103 S Davis St, Albany, GA 31701 | 2018-02-19 |
| 1689198558 | Marion Elizabeth Toscano | Counselor | 226 South Jefferson Street, Frederick, MD 31701 | 2017-08-01 |
| 1871014803 | Mann Dental Care LLC | Clinic/Center | 1403 South Slappey Blvd, Albany, GA 31701 | 2017-06-29 |
| 1457716805 | Amanda Banks Thomas | Advanced Practice Midwife | 803 13th Avenue, Albany, GA 31701 | 2015-12-29 |
| 1265805212 | David Lee Berry Jr. | Counselor | 230 South Jackson Street, Suite 228 & 229, Albany, GA 31701 | 2015-11-12 |
| 1750725099 | Charles Jacob Stoudenmire | Pathology | 507 W 3rd Ave Ste 7, Albany, GA 31701 | 2013-04-17 |
| 1700188232 | Wendy Summer Willis | Podiatrist | 531 Seventh Avenue, Albany, GA 31701 | 2010-12-05 |
| 1760615413 | Nicholas L Misulia | Anesthesiology | 417 Third Avenue, Albany, GA 31701 | 2009-08-28 |
| Find all providers in zip 31701 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750841599 | Kimberly Lashaun Anthony | Community/Behavioral Health | 1517 Lily Pond Rd, Albany, GA 31701-7771 | 2019-03-20 |
| 1285101113 | Chasity S Wright | Community/Behavioral Health | 10151 N Reynard Rd, Albany, IN 47320-9107 | 2018-10-29 |
| 1356821375 | Behaviorway, Inc. | Community/Behavioral Health | 805 Kinkead Way Apt 101, Albany, CA 94706-2636 | 2018-08-20 |
| 1770012288 | Mental Health Association In New York State, Inc. | Community/Behavioral Health | 194 Washington Ave Ste 415, Albany, NY 12210-2314 | 2017-06-08 |
| 1225413610 | Mental Health Empowerment Project, Inc. | Community/Behavioral Health | 3 Atrium Dr Ste 205, Albany, NY 12205-1483 | 2015-07-27 |
| 1154700896 | Burroughs & Jones Counseling and Consulting, LLC | Community/Behavioral Health | 1216 Dawson Rd Ste 110, Burroughs & Jones Counseling and Consulting, LLC, Albany, GA 31707-3800 | 2015-05-27 |
| 1861899759 | Ivy Houses | Community/Behavioral Health | 627 W Highland Ave, Albany, GA 31701-2757 | 2014-11-21 |
| 1548670664 | Holistic Health Systems Inc | Community/Behavioral Health | 345 W Broad Ave Ste 105, Albany, GA 31701-2673 | 2014-04-28 |
| 1548682677 | Doing Good Again LLC | Community/Behavioral Health | 2423 W Alberson Dr, Albany, GA 31721-2025 | 2014-01-08 |
| 1235567918 | Restoration of The Minds LLC | Community/Behavioral Health | 1408 Edgerly Avenue, Albany, GA 31707 | 2013-10-16 |
| Find all providers in ALBANY | ||||
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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.