Healthcare Provider Details

I. General information

NPI: 1215691696
Provider Name (Legal Business Name): WELLIV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2021
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

837 LEE ST SW
ATLANTA GA
30310-2745
US

IV. Provider business mailing address

931 MONROE DR NE STE A102127
ATLANTA GA
30308-1793
US

V. Phone/Fax

Practice location:
  • Phone: 786-831-4348
  • Fax: 302-216-4348
Mailing address:
  • Phone: 786-831-4348
  • Fax: 302-216-1989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DASHIKA DANIELS
Title or Position: RN/OWNER
Credential:
Phone: 786-831-4348