| Key 4 Changes | |
|
405 S Skinner Ave Pooler GA 31322-3225 | |
| (912) 312-3136 | |
| Not Available |
| Full Name | Key 4 Changes |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 405 S Skinner Ave, Pooler, Georgia |
| Authorized Official Name and Position | Harley Strickland (OWNER) |
| Authorized Official Contact | 9123123136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Key 4 Changes 405 S Skinner Ave Pooler GA 31322-3225 Ph: (912) 312-3136 | Key 4 Changes 405 S Skinner Ave Pooler GA 31322-3225 Ph: (912) 312-3136 |
| NPI Number | 1851053508 |
|---|---|
| Provider Enumeration Date | 10/11/2021 |
| Last Update Date | 10/25/2021 |
| Certification Date | 10/25/2021 |
| Medicare PECOS PAC ID | 8426447038 |
|---|---|
| Medicare Enrollment ID | O20211118002969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851053508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Harley Elizabeth Strickland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104400068 PECOS PAC ID: 0244629855 Enrollment ID: I20211118003037 |
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