Healthcare Provider Details

I. General information

NPI: 1477478204
Provider Name (Legal Business Name): ENHANCED WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 UNION BLVD STE 107
SAINT LOUIS MO
63115-1140
US

IV. Provider business mailing address

4200 UNION BLVD STE 107
SAINT LOUIS MO
63115-1140
US

V. Phone/Fax

Practice location:
  • Phone: 314-925-8279
  • Fax: 314-925-8297
Mailing address:
  • Phone: 314-925-8279
  • Fax: 314-925-8297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOYCE SULLIVAN HOWZE
Title or Position: DESIGNATED MANAGER
Credential:
Phone: 314-925-8279