SOUTHWESTERN STATE HOSPITAL (NPI# 1841320280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841320280 |
| Entity Type | Organization |
| Organization Name | SOUTHWESTERN STATE HOSPITAL |
| Practice Address |
1500 Gillionville Rd Ste B Albany GA 31707-3963 |
| Mailing Address |
400 S Pinetree Blvd Patient Billing Dept Thomasville GA 31792-7128 |
| Practice Telephone | 2292272955 |
| Practice Fax Number | 2292272955 |
| Mailing Telephone | 2292272977 |
| Mailing Fax Number | 2292272955 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2009-08-18 |
| Authorized Official Name | MRS. HILARY J HOO-YOU (REGIONAL HOSPITAL ADMINISTRATOR) |
| Authorized Official Telephone | 2292273020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
581130678 | GA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 252378193C | 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 |
| 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 |
| 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 |
1500 GILLIONVILLE RD STE B |
| City | ALBANY |
| State | GA |
| Zip Code | 31707-3963 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396394011 | Barbara Cannon | Technician | 2025 Gail Avenue, Albany, GA 31707 | 2019-09-05 |
| 1669941035 | Wallace Coleman | Counselor | 2403 Osler Court, Suite B, Albany, GA 31707 | 2018-11-15 |
| 1992293955 | Tiffany Timmerman | Massage Therapist | Albany Therapeutic Massage Clinic, 1534 Dawson, Rd, Albany, GA 31707 | 2018-04-25 |
| 1225550957 | Christopher George Solomon | Nurse Practitioner | 2336 Dawson Rd., Urgent Care Center At Phoebe Northwest, Albany, GA 31707 | 2017-07-14 |
| 1689107229 | Teemercare @ Home LLC | Home Health | 1129 Dawson Rd Ste A, Albany, GA 31707 | 2017-04-11 |
| 1205373917 | Nicarro Henderson | Specialist | 2005 E Dawson Rd, Albany, GA 31707 | 2017-01-20 |
| 1235567918 | Restoration of The Minds LLC | Community/Behavioral Health | 1408 Edgerly Avenue, Albany, GA 31707 | 2013-10-16 |
| 1588091334 | Marsha Danell Glover | Pediatrics | 517 N. Westover Blvd., Albany, GA 31707 | 2013-10-10 |
| 1003253139 | Bailey Healthcare Inc | Community/Behavioral Health | 2416 Suite B Westgate Dr, Albany, GA 31707 | 2013-05-30 |
| 1346685666 | Albany Urology Surgery Center LLC | Clinic/Center | 2400 Osler Court, Albany, GA 31707 | 2013-04-30 |
| Find all providers in zip 31707 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376932558 | Hope House, Inc. | Substance Abuse Rehabilitation Facility | 577 Livingston Ave., Albany, NY 12206 | 2015-01-12 |
| 1861664617 | Lasalle School | Substance Abuse Rehabilitation Facility | 391 Western Ave, Albany, NY 12203-1491 | 2008-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477186807 | Reset Recovery Health Center LLC | Substance Abuse Rehabilitation Facility | 6978 Main St, Lithonia, GA 30058 | 2020-02-13 |
| 1538708433 | Bright Star Healthcare Group, LLC | Substance Abuse Rehabilitation Facility | 1545 Pennsylvania Ave, Mcdonough, GA 30253-9114 | 2019-12-26 |
| 1225504368 | New Focus Addiction and Behavioral Health Inc | Substance Abuse Rehabilitation Facility | 45 Eagle Overlook Dr, Dahlonega, GA 30533-6665 | 2018-10-16 |
| 1932652039 | Three Dimensional Life | Substance Abuse Rehabilitation Facility | 4141 Old Cornelia Hwy, Gainesville, GA 30507-7784 | 2016-07-26 |
| 1851455919 | Nptc of Gbch&fm, Inc. | Substance Abuse Rehabilitation Facility | 729 Lawrence St Ne, Marietta, GA 30060-2143 | 2006-12-21 |
| 1437519451 | Shepherd's Hill Academy, Inc | Substance Abuse Rehabilitation Facility | 2200 Price Rd, Martin, GA 30557-3457 | 2016-03-03 |
| 1760766398 | Sharolette Rogers Counseling Services, LLC | Substance Abuse Rehabilitation Facility | 98 Gordon Commercial Dr, Lagrange, GA 30240-5735 | 2011-09-30 |
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.