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Organization

CLAYCON, LLC

Active
Parent organization
CLAYCON LLC DBA: A BRIDGE TO RECOVERY
Other names
The Healing Path Program for Women
Organization subpart
Yes

Provider details

NPI number
Legal business name
CLAYCON LLC DBA: A BRIDGE TO RECOVERY
Authorized official
ANGIE GARRETT (OFFICE MANAGER)
(662) 280-5758
Entity
Organization

Contact information

Practice address
5158 STAGE RD, SUITE 130, MEMPHIS, TN 38134-3116
(662) 280-5758
(662) 280-5708
Mailing address
8829 CENTRE ST, SOUTHAVEN, MS 38671-2610
(662) 280-5758
(662) 280-5708

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
05/10/2011
Last updated
05/10/2011
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