<Unavail>

LBN: Clayton Mhddad
<Unavail> is an health care organization with primary practice located at 6315 Garden Walk Blvd , Riverdale GA 30274-2628. The organization recently has 9 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Agencies / Day Training, Developmentally Disabled Services, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Agencies / Community/Behavioral Health is the primary health care specialty. Clayton Mhddad can be contacted via phone (770) 991-7420, or through Cole, Terry via phone (770) 478-2280.

Contact Information

Primary practice address
6315 Garden Walk Blvd Riverdale GA 30274-2628
Phone: (770) 991-7420
Fax: (770) 991-7429
Website:
Map and Directions
Authorized official contact:
Name: Cole, Terry
Phone: (770) 478-2280

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X

Profile Details

NPI number 1639367543
LBN Legal business name Clayton Mhddad
DBA Doing business as <Unavail>
Authorized official Cole, Terry
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 5th, 2007
Last updated Nov 8th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639367543 NPPES
Georgia MEDICAID 000604250B
Georgia MEDICAID 00604205B

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