Provider Demographics
NPI:1851161327
Name:KEY ELEMENTS WELLNESS & SUPPORT
Entity Type:Organization
Organization Name:KEY ELEMENTS WELLNESS & SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LATONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLATE-KENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-517-2345
Mailing Address - Street 1:14141 SOUTHWEST FWY STE 155
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3493
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14141 SOUTHWEST FWY STE 155
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3493
Practice Address - Country:US
Practice Address - Phone:832-517-2345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health