| Organization Name: | SOUTHWESTERN STATE HOSPITAL COMMUNITY SERVICES |
| NPI Number: | 1013044841 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HILARY J HOO-YOU (REGIONAL HOSPITAL ADMINISTRATOR) |
| Mailing Address: | 400 S Pinetree Blvd Business Office - Patient Billing Dept Thomasville |
| State: | GA US |
| Postal Code: | 317927128 |
| Phone Number: | 2292272977 |
| Fax Number: | 2292272955 |
| NPI Enumeration Date: | 02/28/2007 |
| NPI Last Update Date: | 08/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320900000X |
| License Number: | 581130678 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |