National Provider Identifier Database

SOUTH FORSYTH WELLNESS LLC
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).


Contact Information

SOUTH FORSYTH WELLNESS LLC
6110 MCFARLAND STATION DR STE 1103
ALPHARETTA, GA30004-6801
Phone: 770-203-3998
Fax:
Website:
Specialty Taxonomy Code
* Clinic/Center 261Q00000X
Case Management 251B00000X
Community/Behavioral Health 251S00000X
Health Service 261QH0100X
Medical Specialty 261QM2500X
Mental Health (Including Community Mental Health Center) 261QM0801X

* Indicates primary specialty

NPI Profile & details for SOUTH FORSYTH WELLNESS LLC

NPI Number 1164177085
Legal business name
LBN
SOUTH FORSYTH WELLNESS LLC
Authorized official JOSEPH DIFABIO - (CMO)
Entity Organization
Organization subpart No
Enumeration date 02/18/2022
Last updated 02/18/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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