Provider Demographics
NPI:1235825035
Name:GAINESVILLE MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:GAINESVILLE MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:PERVAIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MSIT
Authorized Official - Phone:470-839-5845
Mailing Address - Street 1:3820 GREY ABBEY DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-6481
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2565 THOMPSON BRIDGE RD STE 111
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1723
Practice Address - Country:US
Practice Address - Phone:470-839-5845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty