Provider Demographics
NPI:1659941623
Name:AVM GROUP, LLC
Entity Type:Organization
Organization Name:AVM GROUP, LLC
Other - Org Name:VINE RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARSHAK
Authorized Official - Middle Name:
Authorized Official - Last Name:KARADJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-974-1823
Mailing Address - Street 1:11696 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2613
Mailing Address - Country:US
Mailing Address - Phone:844-242-1271
Mailing Address - Fax:
Practice Address - Street 1:11696 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2613
Practice Address - Country:US
Practice Address - Phone:844-242-1271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-30
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Single Specialty