Provider Demographics
NPI:1528776341
Name:ALEA HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:ALEA HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-377-2510
Mailing Address - Street 1:226 S WOODS MILL RD STE 55
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3662
Mailing Address - Country:US
Mailing Address - Phone:314-377-2515
Mailing Address - Fax:314-377-2519
Practice Address - Street 1:226 S WOODS MILL RD STE 55
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3662
Practice Address - Country:US
Practice Address - Phone:314-377-2515
Practice Address - Fax:314-377-2519
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALEA HEALTH & WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-10
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty