Organization
CLAYTON CENTER CSB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY TOM-JOHNSON (COO)
(770) 473-2418
Entity
Organization
Contact information
Practice address
133 AUGUSTA DR, MCDONOUGH, GA 30253-4268
(770) 478-2280
(770) 477-9772
Mailing address
157 SMITH ST, JONESBORO, GA 30236-3546
(770) 478-2280
(770) 477-9772
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/13/2016
Last updated
10/19/2016
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