Intensive Treatment Residence Program
LBN: Southwestern State Hospital
Intensive Treatment Residence Program is an health care organization with primary practice located at 307 Cloverdale Dr Intensive Treatment Residence Program, Thomasville GA 31792-4018. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as the primary health care specialty.
Southwestern State Hospital can be contacted via phone (229) 227-2977, or through Hoo-You, Hilary J via phone (229) 227-3021.
Contact Information
Primary practice address
307 Cloverdale Dr Intensive Treatment Residence Program
Thomasville GA 31792-4018
Phone: (229) 227-2977
Fax: (229) 227-2955
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness | 320800000X | 58-1130678 | Georgia |
Profile Details
| NPI number | 1376645796 |
|---|---|
| LBN Legal business name | Southwestern State Hospital |
| DBA Doing business as | Intensive Treatment Residence Program |
| Authorized official | Hoo-You, Hilary J |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 5th, 2006 |
| Last updated | Aug 18th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376645796 | NPPES |
| Georgia | MEDICAID | 252378193A |
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