Provider Demographics
NPI:1619766219
Name:HYGEIA HEALTH
Entity type:Organization
Organization Name:HYGEIA HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EBENEZE
Authorized Official - Middle Name:ADEKUNLE
Authorized Official - Last Name:KOLADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-803-7428
Mailing Address - Street 1:150 MEDICAL WAY STE A
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-2533
Mailing Address - Country:US
Mailing Address - Phone:203-803-7428
Mailing Address - Fax:
Practice Address - Street 1:150 MEDICAL WAY STE A
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2533
Practice Address - Country:US
Practice Address - Phone:203-803-7428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty