Provider Demographics
NPI:1295592343
Name:ENHANCED WELLNESS LLC
Entity type:Organization
Organization Name:ENHANCED WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-925-8279
Mailing Address - Street 1:4200 UNION BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63115-1140
Mailing Address - Country:US
Mailing Address - Phone:314-925-8279
Mailing Address - Fax:314-925-8297
Practice Address - Street 1:4200 UNION BLVD STE 107
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63115-1140
Practice Address - Country:US
Practice Address - Phone:314-925-8279
Practice Address - Fax:314-925-8297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care