Organization
GEORGIA DEPARTMENT OF HUMAN RESOURCES
Active
Parent organization
GEORGIA DEPARTMENT OF HUMAN RESOURCES
Other names
Northwest Georgia Regional Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
GEORGIA DEPARTMENT OF HUMAN RESOURCES
Authorized official
THOMAS MULLER M.D. (CLINICAL DIRECTOR)
(706) 295-6285
Entity
Organization
Contact information
Practice address
705 NORTH DIVISION STREET NW, BUILDING 103 - CLINICAL DIRECTOR'S OFFICE, ROME, GA 30165-1454
(706) 295-6285
Mailing address
705 NORTH DIVISION STREET NW, BUILDING 103 - CLINICAL DIRECTOR'S OFFICE, ROME, GA 30165-1454
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
057-013
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000142172A
—
GA
Enumeration date
07/01/2006
Last updated
09/22/2008
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