| Kiya Club Ctc | |
|
1258 Highway 138 Sw Riverdale GA 30296-1402 | |
| (770) 994-2225 | |
| (770) 994-2226 |
| Full Name | Kiya Club Ctc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1258 Highway 138 Sw, Riverdale, Georgia |
| Authorized Official Name and Position | Angela D Cosby (CEO/OWNER) |
| Authorized Official Contact | 7709942225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kiya Club Ctc 1258 Highway 138 Sw Riverdale GA 30296-1402 Ph: (770) 994-2225 | Kiya Club Ctc 1258 Highway 138 Sw Riverdale GA 30296-1402 Ph: (770) 994-2225 |
| NPI Number | 1982888640 |
|---|---|
| Provider Enumeration Date | 12/18/2007 |
| Last Update Date | 12/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982888640 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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