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General NPI Number Information
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NPI Number | 1629930938
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Entity Type | Organization
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Legal Business Name | REAL WELLNESS ENTERPRISES LLC
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Dates
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Enumeration Date | 11/25/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 755 MOUNT VERNON HWY NE STE 540
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City | ATLANTA
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State | GA
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Zip | 30328-4279
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Country | US
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Telephone | 404-464-8749
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Fax | 678-973-2735
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Provider Business Mailing Address
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Address Line | 755 MOUNT VERNON HWY NE STE 540
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City | ATLANTA
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State | GA
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Zip | 30328-4279
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Country | US
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Telephone | 404-464-8749
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Fax | 678-973-2735
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. JADA MOORE-RUFFIN
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Credential | MD
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Telephone | 404-667-6534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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