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Live Oak Wellness, Llc
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Dunwoody, Georgia
NPI 1730730839

Live Oak Wellness, Llc is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Atlanta, GA. Live Oak Wellness, Llc practices in Dunwoody, GA. The NPI Number for Live Oak Wellness, Llc is 1730730839 and holds a License No. (Georgia).

The current practice location address for Live Oak Wellness, Llc is 1535 Mount Vernon Rd, Dunwoody, GA and can be reached out via phone at 770-845-0586.

Location: 1535 Mount Vernon Rd, Dunwoody, GA, 30356-1128
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1730730839
Provider Name
Live Oak Wellness, Llc
Credential
Provider Entity Type
Organization
Address
1535 Mount Vernon Rd, Dunwoody, GA, 30356-1128
Phone Number
770-845-0586
Fax Number
Provider Enumeration Date
09/20/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1356664007 01 PAUL PANCHAJANYA
institution
Provider Business Practice Location Address Details
Address
1535 Mount Vernon Rd
City
Dunwoody
State
Georgia
Zip
30338-4149
Phone Number
770-845-0586
Fax Number
person
Provider Business Mailing Address Details
Address
1535 Mount Vernon Rd
City
Dunwoody
State
Georgia
Zip
30338-4149
Phone Number
770-845-0586
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Substance Use Disorder
Taxonomy
261QR0405X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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