| Clayton Csb | |
|
4513 Ernest Dr Apt. # 1 & 3 Forest Park GA 30297-3566 | |
| (404) 363-2063 | |
| Not Available |
| Full Name | Clayton Csb |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4513 Ernest Dr, Forest Park, Georgia |
| Authorized Official Name and Position | Terry Cole (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7704782280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clayton Csb 157 Smith St Jonesboro GA 30236-3546 Ph: (770) 478-2280 | Clayton Csb 4513 Ernest Dr Apt. # 1 & 3 Forest Park GA 30297-3566 Ph: (404) 363-2063 |
| NPI Number | 1629266473 |
|---|---|
| Provider Enumeration Date | 10/05/2007 |
| Last Update Date | 11/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629266473 | NPI | - | NPPES |
| 00604205L | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Truliant Health Systems Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 526 Forest Parkway Ste D, Forest Park, GA 30297 Phone: 404-565-0181 Fax: 866-823-4725 | |
Respect Behavior Therapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4868 Ga Highway 85, Forest Park, GA 30297 Phone: 943-200-0016 | |
Truliant Health Systems Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 526 Forest Pkwy, Suite D, Forest Park, GA 30297 Phone: 770-722-1622 Fax: 866-823-4725 | |
Speak:supporting People Emotionally And Kinesthetically Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5953 Shady Lane Cir, Forest Park, GA 30297 Phone: 773-930-7998 | |
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