Organization · Type 2 NPI

Southwestern State Hospital

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Thomasville, GA

NPI number 1497992457 Active

Practice location

309A Shoreline Dr, Community Medicaid Comp Waiver Home
Thomasville, GA 31757-2577

Call (229) 227-2977 Map

Fax (229) 227-2955

Mailing address

PO Box 1378, Patient Billing Dept
Thomasville, GA 31799-1378

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000X320900000X (GA)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1497992457

Southwestern State Hospital's National Provider Identifier is 1497992457, issued on Jan 13, 2009. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Thomasville, GA. The record was last updated on Aug 18, 2009.