CREATIVE WELLNESS, LLC (NPI# 1609307776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609307776 |
| Entity Type | Organization |
| Organization Name | CREATIVE WELLNESS, LLC |
| Other Organization Name | ADVANCED LASER THERAPY AND WELLNESS |
| Practice Address |
2558 S Brentwood Blvd Saint Louis MO 63144-2309 |
| Practice Telephone | 3149618940 |
| Practice Fax Number | 3149618969 |
| Mailing Telephone | 3149618940 |
| Mailing Fax Number | 1439618969 |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2020-06-04 |
| Authorized Official Name | DR. BRIAN HARASHA (OWNER) |
| Authorized Official Telephone | 3149618940 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 2000165042 | MO | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Advanced Laser Therapy and Wellness | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | CREATIVE WELLNESS, LLC | 120-14 Linden Blvd., South Ozone Park, Ny 11420 |
| Street Address |
2558 S BRENTWOOD BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63144-2309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336122266 | Brentwood Physical Therapy Limited | Clinic/Center | 2558 S Brentwood Blvd, Saint Louis, MO 63144-2309 | 2005-11-23 |
| 1558488528 | Brian J Harasha | Chiropractor | 2558 S Brentwood Blvd, Saint Louis, MO 63144-2309 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730681214 | Patrick Kojima | Pharmacist | 1520 S. Brentwood Blvd, Saint Louis, MO 63144 | 2018-03-01 |
| 1104257385 | Karen Misty Thornton | Counselor | 1750 S Brentwood Blvd Ste 503, Saint Louis, MO 63144 | 2013-12-12 |
| 1386804433 | Lisa Marie Ross | Social Worker | 2025 S Brentwood, Suite 206, St Louis, MO 63144 | 2008-06-12 |
| 1568667665 | St. Joseph Institute for The Deaf | Speech-Language Pathologist | 1314 Strassner, Brentwood, MO 63144 | 2007-06-19 |
| 1720292030 | Albert A Barton | Social Worker | 2806 S Brentwood Blvdd, St Louis, MO 63144 | 2007-05-09 |
| 1083736243 | Gary Jean Jameson | Chiropractor | 2901 S Brentwood Blvd, St Louis, MO 63144 | 2007-04-06 |
| 1649340662 | Lindsay Michelle Ledbetter | Physical Therapist | 8228 Brentwood Industrial Drive, Brentwood, MO 63144 | 2006-11-08 |
| 1316041627 | Jandhyala Satya Sagar | Internal Medicine | 1400 Strassner Rd, Brentwood, MO 63144 | 2006-09-08 |
| 1396855326 | Jane E Loitman | Internal Medicine | 8044 Manchester Rd, Saint Louis, MO 63144 | 2006-08-31 |
| 1164532289 | Jayne M Scanlan | Physical Therapist | 2937 South Brentwood Blvd, Brentwood, MO 63144 | 2006-08-30 |
| Find all providers in zip 63144 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871112102 | Thrive St. Louis, Inc | Clinic/Center | 4331 Lindell Blvd, Saint Louis, MO 63108-2701 | 2020-04-16 |
| 1548893530 | Gateway Direct Primary Care Jv LLC | Clinic/Center | 1015 Corporate Square Dr Ste 101, Saint Louis, MO 63132-2938 | 2020-02-18 |
| 1740722230 | Saint Louis Allergy and Asthma Lc | Clinic/Center | 6651 Chippewa St Ste 312, Saint Louis, MO 63109-2532 | 2016-11-15 |
| 1609245448 | Carestl Health | Clinic/Center | 4500 Pope Ave, Saint Louis, MO 63115-2512 | 2015-09-23 |
| 1538586037 | Advanced Cardiovascular Center LLC | Clinic/Center | 2335 Dougherty Ferry Rd, Suite A, Saint Louis, MO 63122-3313 | 2014-03-21 |
| 1871865881 | North County Health Care, Inc | Clinic/Center | 9231 West Florissant, Saint Louis, MO 63136-1432 | 2012-02-07 |
| 1013195478 | Union Manor Residential Care Facility | Clinic/Center | 2711 Union Blvd, Saint Louis, MO 63113-1003 | 2008-02-07 |
| 1497771653 | Instaclinic, LLC | Clinic/Center | 10805 Sunset Office Dr, Suite 300, Saint Louis, MO 63127-1017 | 2006-07-14 |
| 1508867508 | Family Care Health Centers | Clinic/Center | 401 Holly Hills Ave, Saint Louis, MO 63111-2410 | 2005-08-02 |
| 1346847233 | Washington University | Clinic/Center | 8888 Ladue Rd Ste 100, Saint Louis, MO 63124-2056 | 2020-10-05 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63144 |
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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.