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Organization

CLAYTON COMMUNITY SERVICE BOARD

Active
Other names
Clayton Center Behavioral Health
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DOROTHY A. FORTUCHANG MS, LAPC, NCC (SUBSTANCE ABUSE COUNSELOR)
(770) 478-1099
Entity
Organization

Contact information

Practice address
853 BATTLECREEK RD, JONESBORO, GA 30236-1919
(770) 478-1099
(770) 603-4797
Mailing address
853 BATTLECREEK RD, JONESBORO, GA 30236-1919
(770) 478-1099
(770) 603-4797

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
APC002869
GA

Other

Enumeration date
06/12/2012
Last updated
06/12/2012
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