| Live Oak Wellness, Llc | |
|
1535 Mount Vernon Rd Dunwoody GA 30338-4149 | |
| (770) 845-0586 | |
| Not Available |
| Full Name | Live Oak Wellness, Llc |
|---|---|
| Speciality | Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
| Location | 1535 Mount Vernon Rd, Dunwoody, Georgia |
| Authorized Official Name and Position | Andrew Merker (CEO) |
| Authorized Official Contact | 7708450586 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Oak Wellness, Llc Po Box 889128 Atlanta GA 30356-1128 Ph: () - | Live Oak Wellness, Llc 1535 Mount Vernon Rd Dunwoody GA 30338-4149 Ph: (770) 845-0586 |
| NPI Number | 1730730839 |
|---|---|
| Provider Enumeration Date | 09/20/2019 |
| Last Update Date | 01/27/2020 |
| Certification Date | 01/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730730839 | NPI | - | NPPES |
| 1356664007 | Other | PAUL PANCHAJANYA |
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