Healthcare Provider Details

I. General information

NPI: 1477440063
Provider Name (Legal Business Name): WEDA HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8735 DUNWOODY PL STE R
ATLANTA GA
30350-2995
US

IV. Provider business mailing address

PO BOX 3294
MACON GA
31205-3294
US

V. Phone/Fax

Practice location:
  • Phone: 888-988-2924
  • Fax:
Mailing address:
  • Phone: 888-988-2924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. CLARISSA PAUL
Title or Position: CEO
Credential:
Phone: 229-327-7047