KIYA CLUB COMPREHENSIVE TREATMENT CENTER (NPI# 1982888640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982888640 |
| Entity Type | Organization |
| Organization Name | KIYA CLUB COMPREHENSIVE TREATMENT CENTER |
| Other Organization Name | KIYA CLUB CTC |
| Practice Address |
1258 Highway 138 Sw Riverdale GA 30296-1402 |
| Practice Telephone | 7709942225 |
| Practice Fax Number | 7709942226 |
| Mailing Telephone | 7709942225 |
| Mailing Fax Number | 7709942226 |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2007-12-18 |
| Authorized Official Name | DR. ANGELA D COSBY (CEO/OWNER) |
| Authorized Official Telephone | 7709942225 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Kiya Club CTC | Doing Business As Name - Organization |
| Street Address |
1258 HIGHWAY 138 SW |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30296-1402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558594 | James D Hickman | Home Health Aide | 2252 Addison Park, Riverdale, GA 30296 | 2020-11-04 |
| 1255973251 | Octavia Bostic | Nurse's Aide | 7670 Creekside Lane, Riverdale, GA 30296 | 2019-10-10 |
| 1548746829 | Verna Stoner-frazier | Physical Therapist | 1542 Bethaven Rd, Riverdale, GA 30296 | 2018-07-19 |
| 1346762705 | Letty Searcy | Case Manager/Care Coordinator | 7125 E. Village Ct, Riverdale, GA 30296 | 2017-07-07 |
| 1225402639 | Optima Physical Therapy Services | Clinic/Center | 808 Commerce Boulevard, Riverdale, GA 30296 | 2015-11-23 |
| 1437409224 | Mobile Nursing Service LLC | Nursing Care | 829 Scott Rd, Riverdale, GA 30296 | 2012-09-19 |
| 1104069517 | Taina S. Holly | Licensed Practical Nurse | 1234 Elgin Way, Riverdale, GA 30296 | 2009-04-15 |
| 1386720118 | Absolute Healthcare & Rehab Center | Chiropractor | 1807 Hwy 138 Sw, Riverdale, GA 30296 | 2006-10-27 |
| 1467558650 | Daniel Tesfa Redie | Dentist | 1849 Hwy 138, Riverdale, GA 30296 | 2006-09-15 |
| 1033214184 | Malcolm Hill | Chiropractor | 1296 Hwy 138, Suite 105, Riverdale, GA 30296 | 2006-09-13 |
| Find all providers in zip 30296 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790290377 | Your Support Service | Community/Behavioral Health | 6309 Baltimore Ave Ste 201, Riverdale, MD 20737-1059 | 2017-12-05 |
| 1326307257 | A Affordable Dui School LLC | Community/Behavioral Health | 6360 Highway 85, Riverdale, GA 30274-1609 | 2012-05-12 |
| 1407131097 | Global Matrix International Inc. | Community/Behavioral Health | 6030 Hwy 85 Ste 202-4, Riverdale, GA 30274 | 2011-10-15 |
| 1114229440 | Angels Around Us | Community/Behavioral Health | 8915 Creekwood Ct, Riverdale, GA 30274-4601 | 2010-11-18 |
| 1013249283 | Panacea Counseling Services LLC | Community/Behavioral Health | 1436 King Rd, Riverdale, GA 30296-2915 | 2010-02-12 |
| 1568796001 | Ucan | Community/Behavioral Health | 13700 S Indiana Ave, Riverdale, IL 60827-1842 | 2009-10-01 |
| 1023242096 | Tranquility Health Incorporated | Community/Behavioral Health | 113 Upper Riverdale Road, Riverdale, GA 30274 | 2009-05-06 |
| 1104082866 | Clayton Mhddad | Community/Behavioral Health | 269 Valley Hill Rd Sw, Riverdale, GA 30274-2745 | 2008-08-01 |
| 1275713174 | My Sister's Keeper Family Services, Inc. | Community/Behavioral Health | 804 Commerce Blvd Ste A8, Riverdale, GA 30296-3321 | 2007-11-07 |
| 1750560272 | Metro Atlanta Counseling Services, Inc. | Community/Behavioral Health | 6728 Highway 85 Ste A4, Riverdale, GA 30274-2393 | 2007-11-01 |
| Find all providers in RIVERDALE | ||||
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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.