| NPI | 1982888640 |
|---|---|
| Doing Business As | KIYA CLUB CTC |
| Entity Type | Organization |
| Authorized Contact | ANGELA D COSBY CEO/Owner 770-994-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2007-12-18 |