Provider Demographics
NPI:1790085520
Name:A&M COMMUNITY CARE, LLC
Entity Type:Organization
Organization Name:A&M COMMUNITY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:MHA/INF
Authorized Official - Phone:678-234-8242
Mailing Address - Street 1:3711 CALUMET RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-2131
Mailing Address - Country:US
Mailing Address - Phone:404-288-2664
Mailing Address - Fax:
Practice Address - Street 1:2692 COCKLEBUR RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-2139
Practice Address - Country:US
Practice Address - Phone:404-288-2664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health