NPI 1093514200
Advance Wellness Group LLC
Practice location
- Address
- 7915 Olive Blvd, Saint Louis, MO 63130-2020
- Phone
- (314) 665-9134
- Fax
- (314) 453-3897
Authorised official
- Name
- Ebony S Hagens
- Title
- Owner
- Phone
- (314) 665-9134
Registered specialties (7)
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
Home Health Agency
Foster Care Agency
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Physical Disabilities Residential Treatment Facility
Respite Care
Child Intellectual and/or Developmental Disabilities Respite Care
Registry record
- NPI
- 1093514200
- Entity type
- Organization
- NPI issued
- 10 Mar 2025
- Record last updated
- 8 May 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.