MEDICARE: ENHANCED LIFE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372600000X	Adult Companion

General Provider Information

NPI Number	:	1689472854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENHANCED LIFE SERVICES

Provider Business Mailing Address
First Line	:	3706 S 132ND ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68144-3608
Country	:	US
Telephone Number	:	28-308-6434
Fax Number	:

Provider Business Practice Location Address
First Line	:	3706 S 132ND ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68144-3608
Country	:	US
Telephone Number	:	28-308-6434
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LASSOURE SOSTHENE COMPAORE
Credential	:
Telephone Number	:	402-830-8643

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	03/04/2025

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Directions to “ENHANCED LIFE SERVICES ” Practice Location

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