NPIMap

Organization Active NPI

Clayton Center CSB

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • McDonough, GA
National Provider Identifier
1467902437
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
CLAYTON CENTER CSB
Practice address
133 Augusta Dr
McDonough, GA 30253-4268
Phone
(770) 478-2280
Fax
(770) 477-9772
NPI assigned
Oct 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tiffany Tom-Johnson
Title
Coo
Phone
(770) 473-2418

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

133 Augusta Dr
McDonough, GA 30253-4268

Mailing address

157 Smith St
Jonesboro, GA 30236-3546
Phone (770) 478-2280

National Provider Directory

National Provider Directory
Tax ID family
Clayton Mhddad34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476835200000",
    "number": "1467902437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 SMITH ST",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302363546",
            "telephone_number": "770-478-2280",
            "fax_number": "770-477-9772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 AUGUSTA DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534268",
            "telephone_number": "770-478-2280",
            "fax_number": "770-477-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON CENTER CSB",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-19",
        "status": "A",
        "authorized_official_last_name": "TOM-JOHNSON",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "770-473-2418"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.