MEDICARE: SERENITY AND HEAL, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician	66835	GA

General Provider Information

NPI Number	:	1730687880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY AND HEAL, INC

Provider Business Mailing Address
First Line	:	2150 PEACHFORD RD STE A
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30338-6521
Country	:	US
Telephone Number	:	770-674-0553
Fax Number	:	770-674-0554

Provider Business Practice Location Address
First Line	:	6593 MCEVER RD
Second Line	:
City	:	FLOWERY BRANCH
State	:	GA
Zip	:	30542-3860
Country	:	US
Telephone Number	:	770-674-0553
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NAVEED UMMED
Credential	:	MD
Telephone Number	:	770-674-0553

Provider Enumeration Date	:	01/24/2018
Last Update Date	:	01/24/2018

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