Organization
THE KIYA HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA DENISE COSBY (CEO/OWNER)
(770) 994-2223
Entity
Organization
Contact information
Practice address
1256 HIGHWAY 138 SW, RIVERDALE, GA 30296-1402
(770) 994-2223
(770) 994-2224
Mailing address
1256 HIGHWAY 138 SW, RIVERDALE, GA 30296-1402
(770) 994-2223
(770) 994-2224
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
08/23/2007
Last updated
08/23/2007
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