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Organization
LIQUID LOUNGE HYDRATION DBA IDEAL VITALITY WELLNESS
Active
Organization
LIQUID LOUNGE HYDRATION DBA IDEAL VITALITY WELLNESS
Active
Other names
Ideal Vitality Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER GUILLAUME BSN, RN (OPERATOR)
(704) 247-7281
Entity
Organization
Contact information
Practice address
5126 PARK RD STE 2C, CHARLOTTE, NC 28209-3748
(704) 247-7281
(704) 800-5655
Mailing address
5126 PARK RD STE 2C, CHARLOTTE, NC 28209-3748
(704) 247-7281
(704) 800-5655
Taxonomy
Speciality
Code
Description
License number
State
246QL0900X
Laboratory Management Specialist/Technologist
Primary
—
NULL
246QL0900X
Laboratory Management Specialist/Technologist
Primary
—
—
251J00000X
Nursing Care Agency
—
NULL
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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