NPIMap

Organization Active NPI

Southwestern State Hospital

Doing business as Assertive Community Treatment Program

  • Community/Behavioral Health Agency
  • Hahira, GA
National Provider Identifier
1619045291
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
581130678 Issued in GA
Legal business name
SOUTHWESTERN STATE HOSPITAL
Doing business as
Assertive Community Treatment Program
Practice address
819 Tillman St
Patient Billing Dept
Hahira, GA 31632-1451
Phone
(229) 227-2977
Fax
(229) 227-2955
NPI assigned
Dec 1, 2006
Last updated
Aug 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Hilary J Hoo-You
Title
Regtional Hospital Administrator
Phone
(229) 227-3020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 581130678 GA Primary

Addresses

Primary practice location

819 Tillman St
Patient Billing Dept
Hahira, GA 31632-1451

Mailing address

400 South Pinetree Blvd P.O. Box 1378
Patient Billing Dept
Thomasville, GA 31792-1378
Phone (229) 227-2977

Other identifiers 1

IdentifierTypeStateIssuer
00877236GMedicaidGA

Other names 1

  • Assertive Community Treatment Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Department of Behavioral Health Developmental Disabilities Ga53 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

819 Tillman St
Hahira, GA 31632

400 S Pinetree Blvd
Thomasville, GA 31792
Phone (229) 227-2990

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1619045291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SOUTH PINETREE BLVD P.O. BOX 1378",
            "address_2": "PATIENT BILLING DEPT",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317921378",
            "telephone_number": "229-227-2977",
            "fax_number": "229-227-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 TILLMAN ST",
            "address_2": "PATIENT BILLING DEPT",
            "city": "HAHIRA",
            "state": "GA",
            "postal_code": "316321451",
            "telephone_number": "229-227-2977",
            "fax_number": "229-227-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN STATE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "HOO-YOU",
        "authorized_official_first_name": "HILARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "REGTIONAL HOSPITAL ADMINISTRATOR",
        "authorized_official_telephone_number": "229-227-3020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "581130678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00877236G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Assertive Community Treatment Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hahira, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.