Rose Haven Icf/Mr

LBN: Southwestern State Hospital
Rose Haven Icf/Mr is an health care organization with primary practice located at 400 S Pinetree Blvd , Thomasville GA 31792-7128. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Southwestern State Hospital can be contacted via phone (229) 227-3004, or through Hoo-You, Hilary J via phone (229) 227-3020.

Contact Information

Primary practice address
400 S Pinetree Blvd Thomasville GA 31792-7128
Phone: (229) 227-3004
Fax: (227) 227-2663
Website:
Map and Directions
Authorized official contact:
Name: Hoo-You, Hilary J
Phone: (229) 227-3020

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 2-136-832 Georgia

Profile Details

NPI number 1215920525
LBN Legal business name Southwestern State Hospital
DBA Doing business as Rose Haven Icf/Mr
Authorized official Hoo-You, Hilary J
Entity Organization
Organization subpart 1 No
Enumeration date Aug 23rd, 2005
Last updated Aug 18th, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215920525 NPPES
Georgia MEDICAID 00142799A

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