| Clayton Csb | |
|
9698 Holly Hill Way Jonesboro GA 30238-6490 | |
| (770) 471-2971 | |
| (770) 477-9772 |
| Full Name | Clayton Csb |
|---|---|
| Speciality | Respite Care |
| Location | 9698 Holly Hill Way, Jonesboro, Georgia |
| Authorized Official Name and Position | Terry Cole (EXCUTIVE DIRECTOR) |
| Authorized Official Contact | 7704782280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clayton Csb 157 Smith St Jonesboro GA 30236-3546 Ph: (770) 478-2280 | Clayton Csb 9698 Holly Hill Way Jonesboro GA 30238-6490 Ph: (770) 471-2971 |
| NPI Number | 1760670467 |
|---|---|
| Provider Enumeration Date | 10/09/2007 |
| Last Update Date | 11/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760670467 | NPI | - | NPPES |
| 00604205K | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
| 385H00000X | Respite Care | (* (Not Available)) | Primary |
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