# RECHARGED WELLNESS CLUB LLC

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

## Provider details

- **NPI number:** 1639008790
- **Authorized official:** MR. MICHAEL JEROME WILLIAMS SR. AST (OWNER/ ADVANCED BODY RECOVERY PRACT)
- **Authorized official phone:** (229) 234-9512

## Contact information

- **Practice address:** 4510 VALNORTH DR, VALDOSTA, GA 31602-6875
- **Practice address phone:** (229) 234-9512
- **Mailing address:** 4510 VALNORTH DR, VALDOSTA, GA 31602-6875
- **Mailing address phone:** (229) 234-9512

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0800X | Recovery Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/15/2026
- **Last updated:** 05/15/2026