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Organization

DEPARTMENT OF BEHAVIORAL HEALTH & DEV. DISABILITIES

Active
Other names
Southwest Developmental Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. HILARY J HOO-YOU (REGIONAL HOSPITAL ADMINISTRATOR)
(229) 227-3021
Entity
Organization

Contact information

Practice address
400 S PINETREE BLVD, THOMASVILLE, GA 31792-7128
(229) 227-3004
(229) 227-2663
Mailing address
PO BOX 1378, PATIENT BILLING DEPT., THOMASVILLE, GA 31799-1378
(229) 227-3004
(227) 227-2663

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
2-136-1643
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00190484A
GA
Enumeration date
08/23/2005
Last updated
08/18/2009
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