GRACE FOMUNUNG SOLE MBR
NPI 1619612876
Nurse Practitioner - Psychiatric/Mental Health in Dacula, GA
About Grace Fomunung Sole Mbr NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRACE FOMUNUNG SOLE MBR (NPI 1619612876) is a healthcare organization registered as a psychiatric/mental health in Dacula, Georgia and active in the NPI registry since May 2022. The organization lists Grace Fomunung, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Grace Fomunung Sole Mbr is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Grace Fomunung Sole Mbr, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Jehovahs Behavioral Care LLC's NPI number?
The NPI number for Jehovahs Behavioral Care LLC is 1619612876. It was assigned to this organization in the NPPES registry on May 2, 2022. The provider is doing business as Grace Fomunung Sole Mbr.
Where is Jehovahs Behavioral Care LLC located?
Jehovahs Behavioral Care LLC is located at 3206 Thimbleberry Trl, Dacula, GA 30019. The listed phone number is (404) 819-7338.
What is Jehovahs Behavioral Care LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Jehovahs Behavioral Care LLC enrolled in Medicare?
Yes. Jehovahs Behavioral Care LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jehovahs Behavioral Care LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Jehovahs Behavioral Care LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Jehovahs Behavioral Care LLC was last updated on November 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Grace Fomunung Sole Mbr · NPI 1619612876
Psychiatric/Mental Health organization in Dacula, Georgia. Organization record, active in the CMS NPPES registry since May 2, 2022.
## Identity
- **NPI:** 1619612876 (Entity type: Organization)
- **Enumerated:** May 2, 2022
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Legal business name:** Jehovahs Behavioral Care Llc
- **Organization subpart:** No
- **Authorized official:** Grace Fomunung, MANAGER
## Practice location
- **Address:** 3206 THIMBLEBERRY TRL, Dacula, GA 30019-7299
- **Phone:** (404) 819-7338
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 15, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1619612876) · Data from the CMS NPPES public registry.