Provider Demographics
NPI:1619758356
Name:CAYA CLINIC, INC.
Entity Type:Organization
Organization Name:CAYA CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:CSAC, CS-IT
Authorized Official - Phone:608-512-6413
Mailing Address - Street 1:730 AZTALAN DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-3209
Mailing Address - Country:US
Mailing Address - Phone:608-438-2714
Mailing Address - Fax:
Practice Address - Street 1:730 AZTALAN DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-3209
Practice Address - Country:US
Practice Address - Phone:608-438-2714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty