Organization
CLAYTON CENTER CSB
Active
Other names
Paula Crane Center
Organization subpart
No
Provider details
NPI number
Authorized official
LOQUETA MCGHEE (REVENUE UTILIZATION MANAGER)
(770) 478-2280
Entity
Organization
Contact information
Practice address
157 SMITH ST, JONESBORO, GA 30236-3546
(770) 478-2280
(770) 477-9772
Mailing address
1792 MOUNT ZION RD, MORROW, GA 30260-4114
(770) 960-2009
(770) 960-2024
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP2322
MEDICARE
GA
Enumeration date
03/23/2016
Last updated
03/23/2016
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