CLAYTON MHDDAD (NPI# 1588852289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588852289 |
| Entity Type | Organization |
| Organization Name | CLAYTON MHDDAD |
| Other Organization Name | CLAYTON CSB |
| Practice Address |
5818 Thompson Blvd Morrow GA 30260-3910 |
| Mailing Address |
157 Smith St Jonesboro GA 30236-3546 |
| Practice Telephone | 4043636305 |
| Practice Fax Number | 7704779772 |
| Mailing Telephone | 7704782280 |
| Mailing Fax Number | 7704779772 |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2011-11-15 |
| Authorized Official Name | MR. TERRY COLE (EXCUTIVE DIRECTOR) |
| Authorized Official Telephone | 7704782280 |
| Is Organization Subpart | Y |
| Parent Organization Name | CLAYTON MHDDAD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00606922F | 05 |
| Other Name | Type Code |
|---|---|
| Clayton CSB | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518113869 | Clayton Mhddad | Community/Behavioral Health | 1044 Pinecrest Dr, Forest Park, GA 30297-3335 | 2008-08-18 |
| 1427204775 | Clayton Mhddad | Community/Behavioral Health | 6278 Holiday Blvd, Forest Park, GA 30297-4262 | 2008-08-18 |
| 1386890341 | Clayton Mhddad | Community/Behavioral Health | 6944 Fielder Rd, Rex, GA 30273-2414 | 2008-08-11 |
| 1104082866 | Clayton Mhddad | Community/Behavioral Health | 269 Valley Hill Rd Sw, Riverdale, GA 30274-2745 | 2008-08-01 |
| 1639358906 | Clayton Mhddad | Clinic/Center | 1585 Pintail Rd, Jonesboro, GA 30238-6641 | 2007-11-02 |
| 1679761373 | Clayton Mhddad | Clinic/Center | 2081 Logan Dr, Jonesboro, GA 30236-7215 | 2007-10-09 |
| 1942498647 | Clayton Mhddad | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5800 Lillian Ln, Morrow, GA 30260-3965 | 2007-10-09 |
| 1851589550 | Clayton Mhddad | Clinic/Center | 7814 Fielder Rd, Jonesboro, GA 30236-2610 | 2007-10-09 |
| 1497943104 | Clayton Mhddad | Clinic/Center | 901 Walnut Creek Ln, Jonesboro, GA 30238-6465 | 2007-10-09 |
| 1760670467 | Clayton Mhddad | Clinic/Center | 9698 Holly Hill Way, Jonesboro, GA 30238-6490 | 2007-10-09 |
| Street Address |
5818 THOMPSON BLVD |
| City | MORROW |
| State | GA |
| Zip Code | 30260-3910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766605 | C. Alexander Pediatrics LLC | Emergency Medicine | 2180 Rex Road, Morrow, GA 30260 | 2020-10-02 |
| 1578127627 | Osara Dhevmi Malalasekara | Student in an Organized Health Care Education/Training Program | Amc Family Medicine Residency Program, 1000 Corporate Center Dr Suite 200, Morrow, GA 30260 | 2019-04-24 |
| 1902360860 | Katrina Samuels | Technician | 5771 Trammell Rd. Morrow Ga, Morrow, GA 30260 | 2019-01-24 |
| 1679067870 | Atl Sport | Community/Behavioral Health | 5376 Jonesboro Rd, Lake City, GA 30260 | 2018-06-20 |
| 1487184099 | Mamie Rochell Jinks | Driver | 1541 Lakeland Cir, Lake City, GA 30260 | 2017-06-15 |
| 1598202079 | Grace Misi Nteff | Nurse Practitioner | 1000 Clayton Village, Clayton State University, School of Nursing Community, Morrow, GA 30260 | 2017-01-23 |
| 1902357908 | Morrow Family Dentistry, P.C. | Clinic/Center | 6319a Jonesboro Road, Morrow, GA 30260 | 2016-10-14 |
| 1043679418 | Elite Rehab and Weightloss | Chiropractor | 1568 Southlake Pkwy Ste C, Morrow, GA 30260 | 2016-02-15 |
| 1659758985 | Clayton State University | Nurse Practitioner | 5809 Northlake Drive, Bldg 1000, Morrow, GA 30260 | 2015-05-06 |
| 1255731519 | Care First Private Home Care | In Home Supportive Care | 2380 Fairfield Court, Morrow, GA 30260 | 2014-08-23 |
| Find all providers in zip 30260 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033307731 | Clayton Center Mhaddd | Clinic/Center | 1396 Southlake Plaza Drive, Morrow, GA 30260-1756 | 2007-10-09 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.