Provider Demographics
NPI:1225473820
Name:STAYHEALTHY WELLNESS GROUP, LLC
Entity Type:Organization
Organization Name:STAYHEALTHY WELLNESS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGAUGHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-401-4748
Mailing Address - Street 1:2818 NORMAN BERRY DR
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-3500
Mailing Address - Country:US
Mailing Address - Phone:770-401-4748
Mailing Address - Fax:
Practice Address - Street 1:2818 NORMAN BERRY DR
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-3500
Practice Address - Country:US
Practice Address - Phone:770-401-4748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170300000XOther Service ProvidersGenetic Counselor, MSGroup - Multi-Specialty