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NPI Code Detail

MEDICARE: KEVIN SKAGGS QMHS

MEDICARE: KEVIN SKAGGS QMHS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1871099580
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN SKAGGS QMHS
Provider Business Mailing Address
First Line : 885 COMMERCE DR
Second Line :
City : PERRYSBURG
State : OH
Zip : 43551-5267
Country : US
Telephone Number : 419-330-5122
Fax Number :
Provider Business Practice Location Address
First Line : 1776 TREMAINSVILLE RD
Second Line :
City : TOLEDO
State : OH
Zip : 43613-4039
Country : US
Telephone Number : 419-214-0606
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2018
Last Update Date : 04/02/2018

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