Provider Demographics
NPI:1295005155
Name:CLAYCON, LLC
Entity Type:Organization
Organization Name:CLAYCON, LLC
Other - Org Name:TURNING POINT RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-280-5758
Mailing Address - Street 1:8829 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-2610
Mailing Address - Country:US
Mailing Address - Phone:662-280-5758
Mailing Address - Fax:662-280-5708
Practice Address - Street 1:8130 COUNTRY VILLAGE DR STE 102
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-2087
Practice Address - Country:US
Practice Address - Phone:662-280-5758
Practice Address - Fax:662-280-5708
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLAYCON, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000010003101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty