| Organization Name: | BWELL4EVER, LLC |
| NPI Number: | 1043688138 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARLENE GEREN (OWNER) |
| Mailing Address: | 7476 Nashville St Ringgold |
| State: | GA US |
| Postal Code: | 307362358 |
| Phone Number: | 7069353055 |
| Fax Number: | 7069353056 |
| NPI Enumeration Date: | 09/08/2015 |
| NPI Last Update Date: | 09/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 621999 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |