Provider Demographics
NPI:1861074601
Name:AMC GROUP LLC
Entity type:Organization
Organization Name:AMC GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAYAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-585-9094
Mailing Address - Street 1:15925 W TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-3249
Mailing Address - Country:US
Mailing Address - Phone:831-585-9094
Mailing Address - Fax:
Practice Address - Street 1:5311 E VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-1703
Practice Address - Country:US
Practice Address - Phone:831-585-9094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMC GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health