OrganizationActive
Department of Behavioral Health & Developmental Disabilities
NPI 1003049057 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Thomasville, GA
Provider details
- NPI number
- 1003049057
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Hilary Hoo-You, Regional Hospital Administrator(229) 227-3020
- License
- 136-01-076-1 (GA)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 136-01-076-1 (GA)
Residential Treatment Facilities
Practice location
213 Martin Luke King Drive
Community Medicaid Waiver Home
Thomasville, GA 31792-6320
Phone: (229) 227-2977
Fax: (229) 227-2955
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1378
Thomasville, GA 31799-1378
Other names (DBA / former)
- Doing business as
- Southwestern State Hospital
Registry dates
- Enumerated
- 2009-08-25
- Last updated
- 2009-08-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.