CLAYTON MHDDAD (NPI# 1609064450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609064450 |
| Entity Type | Organization |
| Organization Name | CLAYTON MHDDAD |
| Other Organization Name | CLAYTON CSB |
| Practice Address |
9307 Forest Knoll Dr Jonesboro GA 30238-5701 |
| Mailing Address |
112 Broad St Jonesboro GA 30236-3563 |
| Practice Telephone | 7704736124 |
| Mailing Telephone | 7704782280 |
| Mailing Fax Number | 7704779772 |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2008-03-05 |
| Authorized Official Name | MR. JADE BENEFIELD (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 | 00606922C | 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 |
| 1588852289 | Clayton Mhddad | Clinic/Center | 5818 Thompson Blvd, Morrow, GA 30260-3910 | 2007-10-09 |
| 1497943104 | Clayton Mhddad | Clinic/Center | 901 Walnut Creek Ln, Jonesboro, GA 30238-6465 | 2007-10-09 |
| Street Address |
9307 FOREST KNOLL DR |
| City | JONESBORO |
| State | GA |
| Zip Code | 30238-5701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366969636 | K&p Gentle Hnads Homecare | Home Health | 772 Pointe South Pkwy, Apt. 501, Jonesboro, GA 30238 | 2017-08-27 |
| 1568991214 | Rehab Medical, Inc | Durable Medical Equipment & Medical Supplies | 8568 Highway 85, Jonesboro, GA 30238 | 2017-06-07 |
| 1821472077 | Surgivue First Assisting | Nurse Practitioner | 5865 Sinclair Way, Jonesboro, GA 30238 | 2015-07-17 |
| 1518384106 | Visions of Life Behavioral Health Services, Incorporated | Counselor | 754 Chapman Street, Jonesboro, GA 30238 | 2014-03-21 |
| 1942560206 | Terri L Lee | Counselor | 7899 Waterwheel Way, Jonesboro, GA 30238 | 2012-05-21 |
| 1265704985 | Visiting Homecare Support Services, Inc. | Home Health | 10886 Tara Village Way, Jonesboro, GA 30238 | 2012-01-27 |
| 1518297175 | Heavenly Assisted Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10555 Aspenwood Ct, Jonesboro, GA 30238 | 2010-01-05 |
| 1649419821 | Carmen Melton Douglas | Speech-Language Pathologist | 10354 Shepperton Court, Jonesboro, GA 30238 | 2009-02-12 |
| 1205050259 | Caryn Ann Grzesiakowski | Chiropractor | 809 Flint River Road, Suite #4, Jonesboro, GA 30238 | 2007-04-12 |
| 1548325483 | Janet Musser Granski | Social Worker | 110 North Bend Court, Jonesboro, GA 30238 | 2006-12-22 |
| Find all providers in zip 30238 | ||||
| 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 |
|---|---|---|---|---|
| 1073113650 | Secure Foundation Counseling Pllc | Clinic/Center | 125 N Fisher St, Jonesboro, AR 72401-2116 | 2020-10-31 |
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1598398802 | Bhg L, LLC | Clinic/Center | 5510 Southwest Drive, Ste 8, Jonesboro, AR 72404-8352 | 2020-02-14 |
| 1548721525 | Essential Medical and Mental Health Institute | Clinic/Center | 486 Luke Ct, Jonesboro, GA 30238-5798 | 2019-03-30 |
| 1033682612 | Gr8-xpressions Behavioral Health, LLC. | Clinic/Center | 8762 Edenton Way, Jonesboro, GA 30238-4494 | 2019-01-07 |
| 1427416577 | Life Rediscovery Center, LLC | Clinic/Center | 522 Flint Trl, Ste A, Jonesboro, GA 30236-1316 | 2016-02-03 |
| 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 |
| 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 |
| Find all providers in JONESBORO | ||||
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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.