# CLAYTON MHDDAD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CLAYTON MHDDAD
- **Other names:** Clayton CSB
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1760670467
- **Legal business name:** CLAYTON MHDDAD
- **Authorized official:** MR. TERRY COLE (EXCUTIVE DIRECTOR)
- **Authorized official phone:** (770) 478-2280

## Contact information

- **Practice address:** 9698 HOLLY HILL WAY, JONESBORO, GA 30238-6490
- **Practice address phone:** (770) 471-2971
- **Practice address fax:** (770) 477-9772
- **Mailing address:** 157 SMITH ST, JONESBORO, GA 30236-3546
- **Mailing address phone:** (770) 478-2280
- **Mailing address fax:** (770) 477-9772

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | — | — |
| 385H00000X | Respite Care | — | — | Yes |

## Other

- **Enumeration date:** 10/09/2007
- **Last updated:** 11/08/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00604205K | — | GA |