SOUTHWESTERN STATE HOSPITAL (NPI# 1487780227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487780227 |
| Entity Type | Organization |
| Organization Name | SOUTHWESTERN STATE HOSPITAL |
| Practice Address |
400 South Pinetree Blvd Thomasville GA 31792-7128 |
| Mailing Address |
Po Box 1378 Patient Billing Dept Thomasville GA 31799-1378 |
| Practice Telephone | 2292272977 |
| Practice Fax Number | 2292272955 |
| Mailing Telephone | 2292272977 |
| Mailing Fax Number | 2292272955 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-06-04 |
| Authorized Official Name | MRS. BEVERLY B. BAJERSKI (REGIONAL HOSPITAL ADMINISTRATOR) |
| Authorized Official Telephone | 2292273020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | ========= | GA | Hospitals |
| 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 |
400 SOUTH PINETREE BLVD |
| City | THOMASVILLE |
| State | GA |
| Zip Code | 31792-7128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255324588 | Georgia Department of Human Resources | Psychiatric Hospital | 400 South Pinetree Blvd, Thomasville, GA 31792-7128 | 2005-08-23 |
| 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 | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255324588 | Georgia Department of Human Resources | Psychiatric Hospital | 400 South Pinetree Blvd, Thomasville, GA 31792-7128 | 2005-08-23 |
| 1447482880 | Department of Behavioral Health & Developmental Disabilities | Psychiatric Hospital | 400 S Pinetree Blvd, Patient Billing Dept, Thomasville, GA 31792-7128 | 2009-08-19 |
| 1265667463 | Department of Behavioral Health and Developmental Disabilities | Psychiatric Hospital | 400 S Pinetree Blvd, Thomasville, GA 31792-7128 | 2009-05-18 |
| 1083849285 | Department of Behavioral Health and Developmental Disabilities | Psychiatric Hospital | 400 S Pinetree Blvd, Patient Billing Dept, Thomasville, GA 31792-7128 | 2009-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922485804 | Mildred Grant | Psychiatric Hospital | 255 Sumner Lakes Rd, Sumner, GA 31789-4431 | 2015-04-30 |
| 1013259035 | Janet Warrington | Psychiatric Hospital | 438 Clem Lowell Rd, Carrollton, GA 30116-9255 | 2013-03-18 |
| 1093088643 | Ramsay Youth Services of Georgia, Inc. | Psychiatric Hospital | 3500 Riverside Dr, Macon, GA 31210-2509 | 2012-02-13 |
| 1518295518 | Reentry Corporation of America | Psychiatric Hospital | 260 Peachtree St, Atlanta, GA 30303-1202 | 2009-12-02 |
| 1427292333 | Uhs of Savannah LLC | Psychiatric Hospital | 633 Stephenson Ave, Savannah, GA 31405-5970 | 2009-04-22 |
| 1770742132 | Riverwoods Behavioral Health, LLC | Psychiatric Hospital | 223 Medical Center Drive, Riverdale, GA 30274 | 2008-06-02 |
| 1306913736 | Uhs of Laurel Heights, Lp | Psychiatric Hospital | 934 Briarcliff Rd Ne, Atlanta, GA 30306-2618 | 2006-11-29 |
| 1285663385 | Georgia Department of Human Resources | Psychiatric Hospital | 705 North Division Street Nw, Building 103 - Clinical Director's Office, Rome, GA 30165-1454 | 2006-07-01 |
| 1336114321 | Talbott Recovery Campus | Psychiatric Hospital | 5355 Hunter Rd, Atlanta, GA 30349-2594 | 2006-02-22 |
| 1205809571 | Turning Point Care Center LLC | Psychiatric Hospital | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2006-02-08 |
| Find all providers with the same taxonomy | ||||
| City | THOMASVILLE |
| Zip Code | 31792 |
Please comment or provide details below to improve the information on SOUTHWESTERN STATE HOSPITAL.
| 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.