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General NPI Number Information
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NPI Number | 1164358594
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Entity Type | Organization
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Legal Business Name | AMMGW INC., D/B/A FULL CIRCLE WELLNESS
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 323 OKLAND AVENUE
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City | STATEN ISLAND
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State | NY
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Zip | 10310
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Country | US
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Telephone | 347-242-1770
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Fax |
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Provider Business Mailing Address
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Address Line | 191 OLYMPIA BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10305-4223
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Country | US
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Telephone | 347-242-1770
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANNA MENDEZ
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Credential | CASAC ADV, BS
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Telephone | 347-242-1770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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