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Organization
LIVE OAK WELLNESS, LLC
Active
Organization
LIVE OAK WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW MERKER (CEO)
(770) 845-0586
Entity
Organization
Contact information
Practice address
1535 MOUNT VERNON RD, DUNWOODY, GA 30338-4149
(770) 845-0586
Mailing address
PO BOX 889128, ATLANTA, GA 30356-1128
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
09/20/2019
Last updated
01/27/2020
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