Organization
CLAYTON MHDDAD
Active
Organization
CLAYTON MHDDAD
Active
Other names
Clayton CSB
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY COLE (CEO)
(770) 478-2280
Entity
Organization
Contact information
Practice address
1585 PINTAIL RD, JONESBORO, GA 30238-6641
(770) 478-2280
Mailing address
112 BROAD ST, JONESBORO, GA 30236-3563
(770) 478-2280
(770) 477-9772
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00606922AQ
—
GA
Enumeration date
09/23/2010
Last updated
09/23/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up