Organization
KIYA CLUB COMPREHENSIVE TREATMENT CENTER
Active
Other names
Kiya Club CTC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA D COSBY PH.D. (CEO/OWNER)
(770) 994-2225
Entity
Organization
Contact information
Practice address
1258 HIGHWAY 138 SW, RIVERDALE, GA 30296-1402
(770) 994-2225
(770) 994-2226
Mailing address
1258 HIGHWAY 138 SW, RIVERDALE, GA 30296-1402
(770) 994-2225
(770) 994-2226
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/18/2007
Last updated
12/18/2007
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