| Clayton Csb | |
|
9307 Forest Knoll Dr Jonesboro GA 30238-5701 | |
| (770) 473-6124 | |
| Not Available |
| Full Name | Clayton Csb |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 9307 Forest Knoll Dr, Jonesboro, Georgia |
| Authorized Official Name and Position | Jade Benefield (EXCUTIVE DIRECTOR) |
| Authorized Official Contact | 7704782280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clayton Csb 112 Broad St Jonesboro GA 30236-3563 Ph: (770) 478-2280 | Clayton Csb 9307 Forest Knoll Dr Jonesboro GA 30238-5701 Ph: (770) 473-6124 |
| NPI Number | 1609064450 |
|---|---|
| Provider Enumeration Date | 10/05/2007 |
| Last Update Date | 03/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609064450 | NPI | - | NPPES |
| 00606922C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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