| Organization Name: | WELLNESS FOR LIFE LLC |
| NPI Number: | 1720464241 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAURIE COVINGTON (CEO) |
| Mailing Address: | 6 Frazier Way Scott Depot |
| State: | WV US |
| Postal Code: | 255609018 |
| Phone Number: | 3012040863 |
| Fax Number: | |
| NPI Enumeration Date: | 08/06/2015 |
| NPI Last Update Date: | 08/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1971 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |