Ivydale Wellness Center

LBN: Ivydale Wellness Center
Ivydale Wellness Center is an health care organization with primary practice located at 361 Resource Pkwy , Winder GA 30680-8364. The organization recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is the primary health care specialty. Ivydale Wellness Center can be contacted via phone (770) 291-0419, or through Agomessou, Ablavi Adodo via phone (404) 819-8701.

Contact Information

Primary practice address
361 Resource Pkwy Winder GA 30680-8364
Phone: (770) 291-0419
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Agomessou, Ablavi Adodo Nurse Practitioner (NP)
Phone: (404) 819-8701

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X
Ambulatory Health Care Facilities / Primary Care 261QP2300X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1659919066
LBN Legal business name Ivydale Wellness Center
DBA Doing business as Ivydale Wellness Center
Authorized official Agomessou, Ablavi Adodo Nurse Practitioner (NP)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 16th, 2019
Last updated Oct 27th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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