Organization · Type 2 NPI

Jehovahs Behavioral Care LLC

Psychiatric/Mental Health Nurse Practitioner · Dacula, GA

NPI number 1619612876 Active

Practice location

3206 Thimbleberry Trl
Dacula, GA 30019-7299

Call (404) 819-7338 Map

Mailing address

4652 Lawrenceville Hwy NW
Lilburn, GA 30047-3621

Specialties and licenses

Taxonomy	Code	License
Health Service Clinic/Center	261QH0100X	None listed
Adult Mental Health Clinic/Center	261QM0850X	None listed
Adolescent and Children Mental Health Clinic/Center	261QM0855X	None listed
Psychiatric/Mental Health Nurse Practitioner Primary	363LP0808X	None listed

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

Another provider at this address

Grace Tamu Fomunung, NURSE PRACTITIONERPsychiatric/Mental Health Nurse Practitioner Dacula, GA NPI 1679028575

Other psychiatric/mental health nurse practitioner providers in Dacula

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NPI record

NPI: 1619612876
Entity type: Organization (Type 2)
Issued: May 2, 2022
Last updated: Nov 15, 2022
Status: Active

Other names

<unavail>
Grace Fomunung Sole MBR · doing business as
Grace Fomunung Sole MBR · doing business as

Authorized official

Ms. Grace Fomunung, PMHNP
Manager
(404) 819-7338

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1619612876

Jehovahs Behavioral Care LLC's National Provider Identifier is 1619612876, issued on May 2, 2022. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Dacula, GA. The record was last updated on Nov 15, 2022.