Provider Demographics
NPI:1710553094
Name:STAND FIRM HEALTH & WELLNESS
Entity type:Organization
Organization Name:STAND FIRM HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEYONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAUGHTY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:206-390-2652
Mailing Address - Street 1:PO BOX 120745
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-0745
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:279 GRANNIS ST
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-1505
Practice Address - Country:US
Practice Address - Phone:206-390-2652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty