NPI age
5 years
Enumerated 2020-09-12
● Active Type 2 · Organization
Subpart
Ivydale Wellness Center Llc
Ivydale Wellness Center Llc is 1 of 2449 community/behavioral health organizations in Georgia.
Primary specialty
Community/Behavioral Health
Plus 2 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Agomessou
Pmhnp-C
Last NPPES update
2020-09-12
Source: monthly bulk 2026-05
How this organization compares
Across 2449 active community/behavioral health providers in Georgia.
NPI age
5 years
↓ 8 yr below median
Practice locations
1
0 secondary on file
Subspecialties
2
In the 15% of peers with subspecialties
NPI lifetime · 2020 → 2026
2020-09Enumerated in NPPES
2020
2026
Where they practice
Primary practice location
361 Resource Pkwy
Winder, GA 306808364
Mailing address
881 Ivydale Ln
Lawrenceville, GA 300457818
Authorized official
Ablavi Adodo Agomessou, NP
Pmhnp-C
📞 4048198701
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Brendalyne Tamba, FNP Nurse Practitioner NPI 1053925107
Specialties
-
Community/Behavioral Health PrimaryA 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...
-
Clinic/CenterDefinition to come...
-
Clinical Nurse SpecialistDefinition to come...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Ivydale Wellness Clinic
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
Subpart of 19137243.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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