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General NPI Number Information
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NPI Number | 1104149160
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Entity Type | Organization
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Legal Business Name | LIFE HEALING CENTER PC
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Dates
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Enumeration Date | 03/04/2010
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 2160 FOUNTAIN DR
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City | SNELLVILLE
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State | GA
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Zip | 30078-7022
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Country | US
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Telephone | 678-344-8268
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Fax | 888-627-6444
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Provider Business Mailing Address
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Address Line | 2160 FOUNTAIN DR STE 100
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City | SNELLVILLE
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State | GA
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Zip | 30078-7022
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Country | US
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Telephone | 678-344-8268
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Fax | 888-627-6444
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Authorized Official
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Title or Position | OWNER
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Name | MUHAMMAD AHMED
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Credential | MD
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Telephone | 678-344-8268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 061687
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License Number State | GA
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