Organization
HYGEIA HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EBENEZER ADEKUNLE KOLADE MD (VICE PRESIDENT)
(470) 903-2500
Entity
Organization
Contact information
Practice address
150 MEDICAL WAY STE A, RIVERDALE, GA 30274-2533
(203) 803-7428
Mailing address
150 MEDICAL WAY STE A, RIVERDALE, GA 30274-2533
(470) 903-2500
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2800X
Methadone Clinic
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DRUG043370
STATE OF GEORGIA DRUG ABUSE TREATMENT AND EDUCATION PERMIT
GA
01
—
NTP044342
GEORGIA DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES
GA
Enumeration date
05/01/2025
Last updated
04/20/2026
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