Provider Demographics
NPI:1194615575
Name:K E Y S WELLNESS
Entity type:Organization
Organization Name:K E Y S WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-280-6771
Mailing Address - Street 1:6131 N 27TH AVE APT 2086
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85017-1759
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6131 N 27TH AVE APT 2086
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-1759
Practice Address - Country:US
Practice Address - Phone:903-280-6771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health