MEDICARE: STANDING STRONG LEGACY NETWORK

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
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1336082999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STANDING STRONG LEGACY NETWORK

Provider Business Mailing Address
First Line	:	117 ERIN WAY
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-4187
Country	:	US
Telephone Number	:	478-318-7145
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 MOODY RD STE 119
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-6110
Country	:	US
Telephone Number	:	478-318-7145
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	VANESSA CARTER
Credential	:
Telephone Number	:	478-318-7145

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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