Healthcare Provider Details

I. General information

NPI: 1952285181
Provider Name (Legal Business Name): STGI HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2126 OPAL AVE
YELLOWSTONE NATIONAL PARK WY
82190
US

IV. Provider business mailing address

2900 S QUINCY ST STE 888
ARLINGTON VA
22206-2233
US

V. Phone/Fax

Practice location:
  • Phone: 307-344-4965
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE SUZANNE KANG
Title or Position: PROJECT MANAGER
Credential:
Phone: 703-578-6030