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IVYDALE WELLNESS CENTER LLC
NPI 1326653783
Community/Behavioral Health in Winder, GA

Active since September 12, 2020
361 RESOURCE PKWY, WINDER, GA 30680(770) 291-0419 Get Directions Write a Review

NPPES record last updated: September 12, 2020. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Ivydale Wellness Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IVYDALE WELLNESS CENTER LLC (NPI 1326653783), doing business as Ivydale Wellness Clinic, is a healthcare organization registered as a community/behavioral health in Winder, Georgia and active in the NPI registry since September 2020. The organization lists Ablavi Adodo Agomessou, Pmhnp-c, as its authorized official.

NPPES Registry Identity

NPI1326653783
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameIVYDALE WELLNESS CENTER LLC
Location Address361 RESOURCE PKWYWinder, GA 30680-8364
Mailing Address881 Ivydale LnLawrenceville, GA 30045-7818 · (404) 819-8701
Phone(770) 291-0419
Organization SubpartYesParent: 19137243
Authorized OfficialAblavi Adodo AgomessouPmhnp-c · (404) 819-8701
Enumeration DateSeptember 12, 2020
NPPES CertifiedSeptember 12, 2020
✔ NPI 1326653783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
Also ListedClinical Nurse Specialist · Psychiatric/Mental Health, GeropsychiatricTaxonomy 364SP0813X
361 RESOURCE PKWY, Winder, GA 30680
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Other Names 1

Doing Business AsIvydale Wellness Clinic

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRENDALYNE FACIA TAMBA FNP
Nurse Practitioner (Family)
361 RESOURCE PKWY
WINDER, GA 30680
Barrow County (770) 291-0419
IVYDALE WELLNESS CENTER LLC
Nurse Practitioner (Psychiatric/Mental Health)
361 RESOURCE PKWY
WINDER, GA 30680
Barrow County (770) 291-0419

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ivydale Wellness Center LLC's NPI number?

The NPI number for Ivydale Wellness Center LLC is 1326653783. It was assigned to this organization in the NPPES registry on September 12, 2020. The provider is doing business as Ivydale Wellness Clinic.

Where is Ivydale Wellness Center LLC located?

Ivydale Wellness Center LLC is located at 361 Resource Pkwy, Winder, GA 30680. The listed phone number is (770) 291-0419.

What is Ivydale Wellness Center LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Ivydale Wellness Center LLC was last updated on September 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.