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Organization

DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES

Active
Other names
Northwest Georgia Regional Hospital
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS MULLER M.D. (CLINICAL DIRECTOR)
(706) 295-6285
Entity
Organization

Contact information

Practice address
705 N DIVISION ST NW, ROME, GA 30165-1454
(706) 295-6298
Mailing address
705 N DIVISION ST NW, ROME, GA 30165-1454
(706) 295-6298

Taxonomy

Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
057013
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000142172A
GA
01
112002GA
MEDICARE PART B
GA
Enumeration date
05/27/2009
Last updated
01/29/2010
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