Organization
SOUTHWESTERN STATE HOSPITAL
Active
Organization
SOUTHWESTERN STATE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HILARY J HOO-YOU (REGIONAL HOSPITAL ADMINISTRATOR)
(229) 227-3021
Entity
Organization
Contact information
Practice address
210 LOOMIS STREET, INTEGRATION HOME, THOMASVILLE, GA 31792
(229) 227-3004
(227) 227-2663
Mailing address
PO BOX 1378, PATIENT BILLING DEPT, THOMASVILLE, GA 31799-1378
(229) 227-3004
(229) 227-2663
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
136-01-092-8
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
647660886A
—
GA
Enumeration date
08/23/2005
Last updated
08/18/2009
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