Provider Demographics
NPI:1427640002
Name:STAND TOGETHER LIVE
Entity type:Organization
Organization Name:STAND TOGETHER LIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KLING
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:802-777-5499
Mailing Address - Street 1:230 SAINT PAUL ST APT 808
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4643
Mailing Address - Country:US
Mailing Address - Phone:802-777-5499
Mailing Address - Fax:
Practice Address - Street 1:230 SAINT PAUL ST APT 808
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4643
Practice Address - Country:US
Practice Address - Phone:802-777-5499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health