Provider Demographics
NPI:1598414302
Name:STEADFAST CAPITAL HOLDING GROUP INC
Entity Type:Organization
Organization Name:STEADFAST CAPITAL HOLDING GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ETHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAWESA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-395-3670
Mailing Address - Street 1:2 DENNIS RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-1559
Mailing Address - Country:US
Mailing Address - Phone:508-395-3670
Mailing Address - Fax:
Practice Address - Street 1:2 DENNIS RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-1559
Practice Address - Country:US
Practice Address - Phone:508-395-3670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-20
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care