# LIFEGATE HEALTH & WELLNESS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIFEGATE HEALTH & WELLNESS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1508481862
- **Legal business name:** LIFEGATE HEALTH & WELLNESS
- **Authorized official:** EMMANUELLE CHASSAGNE ARNP (OWNER)
- **Authorized official phone:** (954) 770-7059

## Contact information

- **Practice address:** 3784 HARRIS BLVD NW, KENNESAW, GA 30144-6098
- **Practice address phone:** (954) 770-7059
- **Mailing address:** 3784 HARRIS BLVD NW, KENNESAW, GA 30144-6098
- **Mailing address phone:** (954) 770-7059

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 302R00000X | Health Maintenance Organization | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/12/2020
- **Last updated:** 06/12/2020