IVYDALE WELLNESS CENTER LLC

Community/Behavioral Health

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

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Contact Information

IVYDALE WELLNESS CENTER LLC

361 RESOURCE PKWY
WINDER, GA 30680-8364

Phone: 770-291-0419
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Community/Behavioral Health	251S00000X
Primary Care	261QP2300X
Psychiatric/Mental Health, Geropsychiatric	364SP0813X	89	Certified Clinical Nurse Specialist

Indicates primary specialty

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NPI Profile & details for IVYDALE WELLNESS CENTER LLC

NPI #	`1326653783`
LBN Legal business name	IVYDALE WELLNESS CENTER LLC
Authorized official	ABLAVI AGOMESSOU - (PMHNP-C)
Entity	Organization
Organization subpart ¹	Yes
Enumeration date	09/12/2020
Last updated	09/12/2020 - About 6 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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