Healthcare Provider Details

I. General information

NPI: 1720906043
Provider Name (Legal Business Name): LIMBIC CARE NJ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3675 CRESTWOOD PKWY NW STE 350
DULUTH GA
30096-5054
US

IV. Provider business mailing address

100 CHURCH ST FL 8
NEW YORK NY
10007-2614
US

V. Phone/Fax

Practice location:
  • Phone: 912-361-2574
  • Fax:
Mailing address:
  • Phone: 912-361-2547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: YAVAR MOGHIMI
Title or Position: PRESIDENT
Credential: MD
Phone: 912-361-2574