| Organization Name: | CLAYTON MHDDAD |
| NPI Number: | 1033307731 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRY COLE (EXCUTIVE DIRECTOR) |
| Mailing Address: | 6315 Garden Walk Blvd Riverdale |
| State: | GA US |
| Postal Code: | 302742628 |
| Phone Number: | 7709917420 |
| Fax Number: | 7709917429 |
| NPI Enumeration Date: | 10/09/2007 |
| NPI Last Update Date: | 11/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |