Provider Demographics
NPI:1922140631
Name:AMG HEALTHCARE CENTERS INC
Entity Type:Organization
Organization Name:AMG HEALTHCARE CENTERS INC
Other - Org Name:PEACHTREE CENTER NURSING AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:O
Authorized Official - Last Name:CAUGHRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-459-5600
Mailing Address - Street 1:202 ENON SPRINGS RD E
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-3011
Mailing Address - Country:US
Mailing Address - Phone:615-459-5600
Mailing Address - Fax:615-459-7223
Practice Address - Street 1:202 ENON SPRINGS RD E
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-3011
Practice Address - Country:US
Practice Address - Phone:615-459-5600
Practice Address - Fax:615-459-7223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN221313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7440558Medicaid
TN445323Medicaid
TN445323Medicaid