Healthcare Provider Details

I. General information

NPI: 1801606645
Provider Name (Legal Business Name): FOREVER WELLNESS & CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5343 FLORITA DR
TOLEDO OH
43615-3613
US

IV. Provider business mailing address

5343 FLORITA DR
TOLEDO OH
43615-3613
US

V. Phone/Fax

Practice location:
  • Phone: 419-537-3495
  • Fax:
Mailing address:
  • Phone: 419-537-3495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: SHARENA MALLETT
Title or Position: CEO
Credential:
Phone: 419-537-3495