Provider Demographics
NPI:1316181365
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:EXECUTIVE ASSISTANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:MERRILLE
Authorized Official - Middle Name:S
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-510-5264
Mailing Address - Street 1:8829 CENTRE STREET
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671
Mailing Address - Country:US
Mailing Address - Phone:662-280-5758
Mailing Address - Fax:662-280-5708
Practice Address - Street 1:8829 CENTRE STREET
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671
Practice Address - Country:US
Practice Address - Phone:662-280-5758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
TPR-BADA-SAPT- 01261QR0405X
TPR-BADA-APH-01261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty