Organization
CLAYTON COMMUNITY MENTAL HEALTH SUBSTANCE AB
Active
Parent organization
CLAYTON COMMUNITY MENTAL HEALTH SUBSTANCE ABUSE DEVE SVCS BOARD
Other names
Clayton CSB
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLAYTON COMMUNITY MENTAL HEALTH SUBSTANCE ABUSE DEVE SVCS BOARD
Authorized official
MARKETEIA GANT (CFO)
(770) 605-1126
Entity
Organization
Contact information
Practice address
853 BATTLECREEK RD, JONESBORO, GA 30236-1919
(770) 478-1099
(770) 478-8722
Mailing address
112 BROAD ST, JONESBORO, GA 30236-3563
(770) 478-2280
(770) 478-8722
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00604205E
—
GA
01
—
GRP2322
MEDICARE
GA
Enumeration date
09/08/2008
Last updated
03/04/2011
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