BACK TO LIFE WELLNESS CENTER, INC. (NPI# 1548487671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548487671 |
| Entity Type | Organization |
| Organization Name | BACK TO LIFE WELLNESS CENTER, INC. |
| Practice Address |
2331 Hampton Ave Saint Louis MO 63139-2908 |
| Mailing Address |
54 Fountainvew Dr Saint Charles MO 63303-3049 |
| Practice Telephone | 3142809730 |
| Mailing Telephone | 3142809730 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SHARLENE D SCRUGGS (PRESIDENT) |
| Authorized Official Telephone | 3142809730 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
MO | Ambulatory Health Care Facilities |
| Street Address |
2331 HAMPTON AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63139-2908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528046489 | National Medical Information Svcs | Family Medicine | 2331 Hampton Ave, Saint Louis, MO 63139-2908 | 2006-01-02 |
| 1639442718 | Mo Health LLC | General Practice | 2331 Hampton Ave, Saint Louis, MO 63139-2908 | 2012-02-20 |
| 1255602751 | National Medical Inc | Family Medicine | 2331 Hampton Ave, Saint Louis, MO 63139-2908 | 2012-01-16 |
| 1205159761 | Allegiance Medical X-ray LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2331 Hampton Ave, Saint Louis, MO 63139-2908 | 2010-03-11 |
| 1023342391 | Allegiance Medical Services | Clinical Medical Laboratory | 2331 Hampton Ave, Lower Level, Saint Louis, MO 63139-2908 | 2009-09-19 |
| 1487857090 | Dng Pharmaceuticals | Pharmacy | 2331 Hampton Ave, Saint Louis, MO 63139-2908 | 2007-06-10 |
| 1346228202 | On Call Physicians, LLC | Emergency Medicine | 2331 Hampton Ave, Saint Louis, MO 63139-2908 | 2006-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174160337 | Dawn Martina Clark | Social Worker | 1150 Graham Road, St. Louis, MO 63139 | 2019-12-06 |
| 1013479716 | Cerner Health Connections, Inc. | Pharmacy | 1403 Hampton Avenue, St. Louis, MO 63139 | 2019-04-02 |
| 1447699335 | Beth Renee Groenke | Dentist | 1403 Hampton Ave, St. Louis, MO 63139 | 2013-06-24 |
| 1295866648 | Occupational Health Centers of Kansas Pa | Clinic/Center | 6726 Manchester Road, St. Louis, MO 63139 | 2007-03-08 |
| 1912069733 | Daniel G Armbruster Dc PC | Acupuncturist | 2730 Watson Rd, St Louis, MO 63139 | 2006-12-15 |
| 1831250125 | Kathia Denise Betts | Counselor | 3309 S. Kingshighway Blvd., St.louis, MO 63139 | 2006-12-12 |
| 1841350220 | Denzel Dean Jines II | Dentist | 2340 Hampton Avenue, Suite 3, St. Louis, MO 63139 | 2006-12-08 |
| 1285718163 | Rakhshanda Hassan | Psychiatry & Neurology | St Louis Psychiatric Rehabilitation Center, 5300 Arsenal, St Louis, MO 63139 | 2006-10-25 |
| 1952490682 | City of St. Louis | Ambulance | 2634 Hampton Avenue, City of St Louis Emergency Medical Services, St Louis, MO 63139 | 2006-10-12 |
| 1104917434 | Select Physical Therapy Holdings Inc | Clinic/Center | 1900 South Hampton, St Louis, MO 63139 | 2006-09-28 |
| Find all providers in zip 63139 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053820175 | Prorehab PC | Clinic/Center | 11525 Olde Cabin Rd Ste 1, Saint Louis, MO 63141-7146 | 2017-09-20 |
| 1811447840 | Crystal Cunetto | Clinic/Center | 1114 Ridgelynn Dr, Saint Louis, MO 63124-1220 | 2016-10-13 |
| 1720429558 | Missouri Physical Therapy LLC | Clinic/Center | 9751 Clayton Rd, Saint Louis, MO 63124-1503 | 2013-07-09 |
| 1205067857 | Therapeutic Innovations Lc | Clinic/Center | 563 Cliff Cave Rd, Saint Louis, MO 63129-4415 | 2009-07-30 |
| 1639200074 | Occupational Health Centers of Kansas Pa | Clinic/Center | 1617 S 3rd St, Saint Louis, MO 63104-3839 | 2007-03-08 |
| 1629109087 | Occupational Health Centers of Kansas Pa | Clinic/Center | 8340 N Broadway, Saint Louis, MO 63147-2333 | 2007-03-08 |
| 1194778183 | Prorehab, PC | Clinic/Center | 3726 S Kingshighway Blvd, Saint Louis, MO 63109-1800 | 2006-05-18 |
| 1124071238 | Prorehab, PC | Clinic/Center | 107 Concord Plaza Shopping Ctr, Saint Louis, MO 63128-1307 | 2006-05-18 |
| 1336122266 | Brentwood Physical Therapy Limited | Clinic/Center | 2558 S Brentwood Blvd, Saint Louis, MO 63144-2309 | 2005-11-23 |
| 1699269928 | Physical Therapy Collective, LLC | Clinic/Center | 4642 Shenandoah Ave, Saint Louis, MO 63110-3424 | 2018-06-20 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63139 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.