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LIVE OAK WELLNESS, LLC
NPI 1730730839
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Dunwoody, GA

Active since September 20, 2019CLIA 11D2172991 · Waiver
1535 MOUNT VERNON RD, DUNWOODY, GA 30338(770) 845-0586 Get Directions Write a Review

NPPES record last updated: January 27, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 27, 2020, Jan 22, 2020, Sep 20, 2019 (3 updates tracked since 2019).

About Live Oak Wellness, Llc NPPES

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

LIVE OAK WELLNESS, LLC (NPI 1730730839) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Dunwoody, Georgia and active in the NPI registry since September 2019. The organization holds a CLIA Waiver certificate valid through October 2, 2027 and lists Andrew Merker, Ceo, as its authorized official.

NPPES Registry Identity

NPI1730730839
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameLIVE OAK WELLNESS, LLC
Location Address1535 MOUNT VERNON RDDunwoody, GA 30338-4149
Mailing AddressPo Box 889128Atlanta, GA 30356-1128
Phone(770) 845-0586
Organization SubpartNo
Authorized OfficialAndrew MerkerCeo · (770) 845-0586
Enumeration DateSeptember 20, 2019
Last NPPES UpdateJanuary 27, 20203 updates tracked since enumeration
✔ NPI 1730730839 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
1535 MOUNT VERNON RD, Dunwoody, GA 30338
Open in Google Maps ↗

Other Identifiers 1

Other1356664007Paul Panchajanya

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2172991

Live Oak Wellness, LLC · Dunwoody, GA
Active · expires Oct 2, 2027
CLIA Number11D2172991
Laboratory TypeTissue Bank/Repositories
Certificate Effective DateOctober 3, 2025
Certificate Expiration DateOctober 2, 2027
Laboratory DirectorBenjamin Herrera
Laboratory Phone(770) 238-2674
Laboratory LocationLive Oak Wellness, LLC1535 Mount Vernon Road, Dunwoody, GA 30338
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

KATHERINE MARIA GMITRO
Social Worker
1535 MOUNT VERNON RD
DUNWOODY, GA 30338
Dekalb County (470) 450-0237
DEANNA HARDER NP
Nurse Practitioner (Psychiatric/Mental Health)
1535 MOUNT VERNON RD
DUNWOODY, GA 30338
Dekalb County (470) 504-1668
JONIELLE MONET ANDERSON PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1535 MOUNT VERNON RD
DUNWOODY, GA 30338
Dekalb County (470) 291-4925

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 Live Oak Wellness, LLC's NPI number?

The NPI number for Live Oak Wellness, LLC is 1730730839. It was assigned to this organization in the NPPES registry on September 20, 2019.

Where is Live Oak Wellness, LLC located?

Live Oak Wellness, LLC is located at 1535 Mount Vernon Rd, Dunwoody, GA 30338. The listed phone number is (770) 845-0586.

What is Live Oak Wellness, LLC's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

Does Live Oak Wellness, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2172991) is associated with this NPI, valid through October 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Live Oak Wellness, LLC was last updated on January 27, 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.