Organization
CREATIVE LIFE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD S AHMED MD (CEO)
(678) 344-8268
Entity
Organization
Contact information
Practice address
1637 ATHENS HWY STE B, GRAYSON, GA 30017-1768
(678) 344-8269
(888) 627-6444
Mailing address
1637 ATHENS HWY, GRAYSON, GA 30017-1768
(678) 344-8268
(888) 627-6444
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0805X
Geriatric Psychiatry Physician
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
10/17/2019
Last updated
05/18/2021
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