# EXECUTIVE LEVEL WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265829626
- **Authorized official:** DAVID BRIAN HUGHES GNP-BC (OWNER)
- **Authorized official phone:** (731) 571-8808

## Contact information

- **Practice address:** 111 STONEBRIDGE BLVD, JACKSON, TN 38305-2040
- **Practice address phone:** (731) 420-3334
- **Practice address fax:** (888) 318-1702
- **Mailing address:** 1167 JR JONES RD, HUMBOLDT, TN 38343-8080
- **Mailing address phone:** (731) 571-8808
- **Mailing address fax:** (888) 318-1702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | APN013215 | TN | Yes |

## Other

- **Enumeration date:** 04/22/2015
- **Last updated:** 04/22/2015