Provider Demographics
NPI:1841645397
Name:UMMAHTEK & ASSOCIATES, INC.
Entity type:Organization
Organization Name:UMMAHTEK & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ISLAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CADCII
Authorized Official - Phone:404-734-8376
Mailing Address - Street 1:165 MARION PL NE
Mailing Address - Street 2:UNIT 605
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-2747
Mailing Address - Country:US
Mailing Address - Phone:404-734-8376
Mailing Address - Fax:470-312-2990
Practice Address - Street 1:100 BRAXTON CT
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-1968
Practice Address - Country:US
Practice Address - Phone:770-284-1988
Practice Address - Fax:470-312-2990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA131 101400000YOtherSEC
GA91 261QR0405XOtherSEC