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
—
—
251J00000X
Nursing Care Agency
—
—
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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