Organization
ELLIJAY CENTER FOR CHANGE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL KEATS LCSW (OWNER)
(706) 698-2400
Entity
Organization
Contact information
Practice address
89 HOSPITAL CIR, SUITE 8, ELLIJAY, GA 30540-9669
(706) 698-2400
(706) 698-2401
Mailing address
89 HOSPITAL CIR, SUITE 8, ELLIJAY, GA 30540-9669
(706) 698-2400
(706) 698-2401
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CSW001990
GA
Other
Enumeration date
11/30/2009
Last updated
11/30/2009
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