Provider Demographics
NPI:1689472854
Name:ENHANCED LIFE SERVICES
Entity type:Organization
Organization Name:ENHANCED LIFE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LASSOURE
Authorized Official - Middle Name:SOSTHENE
Authorized Official - Last Name:COMPAORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-830-8643
Mailing Address - Street 1:3706 S 132ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3608
Mailing Address - Country:US
Mailing Address - Phone:028-308-6434
Mailing Address - Fax:
Practice Address - Street 1:3706 S 132ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3608
Practice Address - Country:US
Practice Address - Phone:028-308-6434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty