Provider Demographics
NPI:1326645946
Name:LIFE ENHANCEMENTS HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:LIFE ENHANCEMENTS HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LANA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-755-2570
Mailing Address - Street 1:119 CHURCH ST STE 224
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:MO
Mailing Address - Zip Code:63135-2442
Mailing Address - Country:US
Mailing Address - Phone:314-764-2309
Mailing Address - Fax:314-764-2306
Practice Address - Street 1:119 CHURCH ST STE 224
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135-2442
Practice Address - Country:US
Practice Address - Phone:314-764-2309
Practice Address - Fax:314-764-2306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-06
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care