Organization
LIFEGATE HEALTH & WELLNESS
Active
Parent organization
LIFEGATE HEALTH & WELLNESS
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFEGATE HEALTH & WELLNESS
Authorized official
EMMANUELLE CHASSAGNE ARNP (OWNER)
(954) 770-7059
Entity
Organization
Contact information
Practice address
3784 HARRIS BLVD NW, KENNESAW, GA 30144-6098
(954) 770-7059
Mailing address
3784 HARRIS BLVD NW, KENNESAW, GA 30144-6098
(954) 770-7059
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
302R00000X
Health Maintenance Organization
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/12/2020
Last updated
06/12/2020
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