Healthcare Provider Details

I. General information

NPI: 1003531427
Provider Name (Legal Business Name): LW CONCIERGE NURSE ADVOCATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2022
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8011 CLAYTON RD STE 209
SAINT LOUIS MO
63117-1156
US

IV. Provider business mailing address

8011 CLAYTON RD STE 209
SAINT LOUIS MO
63117-1156
US

V. Phone/Fax

Practice location:
  • Phone: 314-802-6231
  • Fax:
Mailing address:
  • Phone: 314-802-6231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LATASHA MARIE WREN
Title or Position: CEO & CHIEF CAREGIVING OFFICER
Credential: RN, LNC, LTCP
Phone: 314-802-6231