Provider Demographics
NPI:1063970614
Name:AMG HEALTHCARE LLC
Entity type:Organization
Organization Name:AMG HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DESIGNEE
Authorized Official - Prefix:
Authorized Official - First Name:AIKO MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-582-5991
Mailing Address - Street 1:3951 SCENIC VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-6602
Mailing Address - Country:US
Mailing Address - Phone:907-929-0614
Mailing Address - Fax:907-929-0614
Practice Address - Street 1:3951 SCENIC VIEW DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-6602
Practice Address - Country:US
Practice Address - Phone:907-929-0614
Practice Address - Fax:907-929-0614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-03
Last Update Date:2019-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility