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General NPI Number Information
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NPI Number | 1265323620
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Entity Type | Organization
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Legal Business Name | LIFEMATE BEHAVIORAL AND PSYCHIATRY LLC
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 2470 DANIELLS BRIDGE RD STE 161
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City | ATHENS
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State | GA
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Zip | 30606-6196
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Country | US
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Telephone | 470-478-5066
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Fax | 470-478-5066
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Provider Business Mailing Address
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Address Line | 4823 HIGHLAND WOOD DR
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City | AUBURN
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State | GA
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Zip | 30011-2455
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Country | US
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Telephone | 404-275-4136
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Fax | 404-275-4136
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Authorized Official
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Title or Position | CEO
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Name | FRANCIS KAJUMBA
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Credential |
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Telephone | 470-478-5066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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