JEHOVAHS BEHAVIORAL CARE LLC NPI 1619612876

NPI Information

  • NPI: 1619612876
  • Provider Name: JEHOVAHS BEHAVIORAL CARE LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Doing Business As: GRACE FOMUNUNG SOLE MBR
  • Address: 3206 THIMBLEBERRY TRL
    DACULA, GA
    ZIP 30019
  • Phone: (404) 819-7338

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NPI Details

JEHOVAHS BEHAVIORAL CARE LLC is a psychiatric/mental health nurse practitioner in Dacula, GA. JEHOVAHS BEHAVIORAL CARE LLC NPI is 1619612876. The provider is registered as an organization entity type.
The provider Is Doing Business As Grace Fomunung Sole Mbr.

The provider's business location address is:

3206 THIMBLEBERRY TRL
DACULA, GA
ZIP 30019-299
Phone: (404) 819-7338

The provider's authorized official is Grace Fomunung .
The authorized official title is Manager and has the following contact phone number (404) 819-7338.

The enumeration date for this NPI number is 5/2/2022 and was last updated on 11/15/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QH0100XClinic/CenterHealth ServiceNo
2261QM0850XClinic/CenterAdult Mental HealthNo
3261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
4363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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