NPI 1003049057

Department of Behavioral Health & Developmental Disabilities

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Thomasville, GA

Practice location

Address: 213 Martin Luke King Drive Community Medicaid Waiver Home, Thomasville, GA 31792-6320
Phone: (229) 227-2977
Fax: (229) 227-2955
Mailing address: PO Box 1378 Patient Billing Dept, Thomasville, GA 31799-1378

Authorised official

Name: Hilary J Hoo-You
Title: Regional Hospital Administrator
Phone: (229) 227-3020

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence 136-01-076-1 (GA)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Georgia →

Registry record

NPI: 1003049057
Entity type: Organization
NPI issued: 25 Aug 2009
Record last updated: 25 Aug 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.