Organization · Type 2 NPI

Clayton Center

Mental Illness Community Based Residential Treatment Facility · Riverdale, GA

NPI number 1760999643 Active

Practice location

5930 Highway 85 Unit 104
Riverdale, GA 30274-1502

Call (770) 997-8137 Map

Mailing address

157 Smith St
Jonesboro, GA 30236-3546

Other practice locations

5930 Highway 85 Unit 101, Riverdale, GA 30274-1502 · (770) 997-8137

Specialties and licenses

Taxonomy	Code	License
Mental Illness Community Based Residential Treatment Facility Primary	320800000X	None listed

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Another provider at this address

Clayton Center MhadddMental Illness Community Based Residential Treatment Facility Riverdale, GA NPI 1245747138

Other mental illness community based residential treatment facility providers in Riverdale

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NPI record

NPI: 1760999643
Entity type: Organization (Type 2)
Issued: Jan 2, 2018
Last updated: Jun 16, 2018
Status: Active
Subpart: Yes of Clayton Center Mhaddd

Other names

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Clayton Center Holly Tree 101 · doing business as
Clayton Center Holly Tree 104 · doing business as

Authorized official

Tiffany Tom-Johnson
COO
(770) 478-2280

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1760999643

Clayton Center's National Provider Identifier is 1760999643, issued on Jan 2, 2018. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Riverdale, GA. The record was last updated on Jun 16, 2018.