| Clayton Mhddad | |
|
1044 Pinecrest Dr Forest Park GA 30297-3335 | |
| (770) 478-2280 | |
| (770) 477-9772 |
| Full Name | Clayton Mhddad |
|---|---|
| Speciality | Day Training, Developmentally Disabled Services |
| Location | 1044 Pinecrest Dr, Forest Park, Georgia |
| Authorized Official Name and Position | Jade Benefield (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7704782280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clayton Mhddad 112 Broad St Jonesboro GA 30236-3563 Ph: (770) 478-2280 | Clayton Mhddad 1044 Pinecrest Dr Forest Park GA 30297-3335 Ph: (770) 478-2280 |
| NPI Number | 1518113869 |
|---|---|
| Provider Enumeration Date | 08/18/2008 |
| Last Update Date | 08/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518113869 | NPI | - | NPPES |
| 000606922AI | Medicaid | GA |
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