| Solutions For Change, Llc. | |
|
511 S Davis Ave Cleveland MS 38732-3924 | |
| (662) 441-0610 | |
| (662) 441-0614 |
| Full Name | Solutions For Change, Llc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 511 S Davis Ave, Cleveland, Mississippi |
| Authorized Official Name and Position | Trayceea Ray (LICENSED CERTIFIED SOCIAL WORKER) |
| Authorized Official Contact | 6625880025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Solutions For Change, Llc. Po Box 342 Cleveland MS 38732-0342 Ph: (662) 441-0061 | Solutions For Change, Llc. 511 S Davis Ave Cleveland MS 38732-3924 Ph: (662) 441-0610 |
| NPI Number | 1124713268 |
|---|---|
| Provider Enumeration Date | 04/05/2023 |
| Last Update Date | 04/05/2023 |
| Certification Date | 04/05/2023 |
| Medicare PECOS PAC ID | 0749655512 |
|---|---|
| Medicare Enrollment ID | O20230410000059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124713268 | NPI | - | NPPES |
| 02275296 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Trayceea A Ray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548772643 PECOS PAC ID: 4789014176 Enrollment ID: I20200427001650 |
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