ADVANCE WELLNESS GROUP LLC – NPI #1093514200
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

ADVANCE WELLNESS GROUP LLC is a community based residential treatment facility located in SAINT LOUIS, MO. NPPES has assigned the NPI number 1093514200 to ADVANCE WELLNESS GROUP LLC on March 10, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities. Please note, simply having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was last updated on May 08, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ADVANCE WELLNESS GROUP LLC below.

NPI Profile for
ADVANCE WELLNESS GROUP LLC

NPI Number
1093514200
Enumeration Date

(more than a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ADVANCE WELLNESS GROUP LLC
Primary location
7915 OLIVE BLVD
SAINT LOUIS, MO 63130-2020
Phone: (314) 665-9134 Fax: (314) 453-3897
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
EBONY HAGENS
OWNER
Phone: (314) 665-9134
Updated
Certification Date
May 08, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)
385HR2060X
- Respite Care / Respite Care, Intellectual and/or Developmental Disabilities, Child
385H00000X
- Respite Care
320700000X
- Residential Treatment Facility, Physical Disabilities
320600000X
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
253J00000X
- Foster Care Agency
251E00000X
- Home Health

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.