Organization · Type 2 NPI

Southwestern State Hospital

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

NPI number 1871675934 Active

Practice location

8 Belmont Dr, Community Medicaid Waiver Home Chss
Thomasville, GA 31792-4725

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 320900000X136-01-076-1 (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 1871675934

Southwestern State Hospital's National Provider Identifier is 1871675934, issued on Oct 19, 2006. 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.