Provider Demographics
NPI:1609369271
Name:KEY WELLNESS, INC.
Entity Type:Organization
Organization Name:KEY WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:337-718-8041
Mailing Address - Street 1:10 BOULDER CRESCENT ST STE 102
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3350
Mailing Address - Country:US
Mailing Address - Phone:337-718-8041
Mailing Address - Fax:
Practice Address - Street 1:10 BOULDER CRESCENT ST STE 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903
Practice Address - Country:US
Practice Address - Phone:337-718-8041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty