Provider Demographics
NPI:1851053508
Name:KEY 4 CHANGES LLC
Entity Type:Organization
Organization Name:KEY 4 CHANGES LLC
Other - Org Name:KEY 4 CHANGES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-312-3136
Mailing Address - Street 1:405 S SKINNER AVE
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-3225
Mailing Address - Country:US
Mailing Address - Phone:912-312-3136
Mailing Address - Fax:
Practice Address - Street 1:405 S SKINNER AVE
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-3225
Practice Address - Country:US
Practice Address - Phone:912-312-3136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-11
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health