Clayton Csb

LBN: Clayton Mhddad
Clayton Csb is an health care organization with primary practice located at 157 Smith St , Jonesboro GA 30236-3546. The organization recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Psychologist, Agencies / Day Training, Developmentally Disabled Services, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Agencies / Day Training, Developmentally Disabled Services is the primary health care specialty. Clayton Mhddad can be contacted via phone (770) 478-2280, or through Cole, Terry via phone (770) 478-2280.

Contact Information

Primary practice address
157 Smith St Jonesboro GA 30236-3546
Phone: (770) 478-2280
Fax: (770) 477-9772
Website:
Map and Directions
Authorized official contact:
Name: Cole, Terry
Phone: (770) 478-2280

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1548458441
LBN Legal business name Clayton Mhddad
DBA Doing business as Clayton Csb
Authorized official Cole, Terry
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 5th, 2007
Last updated Nov 8th, 2011 - about 13 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 1548458441 NPPES
Georgia MEDICAID 00604205D
Georgia MEDICAID 00881218A
Georgia MEDICAID 00586176F
Georgia MEDICAID 00626249C
Georgia MEDICAID 00884056A
Georgia MEDICAID 00606922B

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