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General NPI Number Information
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NPI Number | 1619766219
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Entity Type | Organization
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Legal Business Name | HYGEIA HEALTH
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 150 MEDICAL WAY STE A
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City | RIVERDALE
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State | GA
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Zip | 30274-2533
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Country | US
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Telephone | 203-803-7428
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Fax |
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Provider Business Mailing Address
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Address Line | 150 MEDICAL WAY STE A
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City | RIVERDALE
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State | GA
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Zip | 30274-2533
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Country | US
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Telephone | 470-903-2500
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. EBENEZER ADEKUNLE KOLADE
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Credential | MD
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Telephone | 470-903-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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