Provider Demographics
NPI:1003360900
Name:AFESTIN INC.
Entity Type:Organization
Organization Name:AFESTIN INC.
Other - Org Name:AFESTIN HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:DINGLASAN
Authorized Official - Last Name:FESTIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:714-930-5738
Mailing Address - Street 1:2107 W GRAYSON AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1621
Mailing Address - Country:US
Mailing Address - Phone:714-817-9424
Mailing Address - Fax:
Practice Address - Street 1:2107 W GRAYSON AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1621
Practice Address - Country:US
Practice Address - Phone:714-817-9424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306005200320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities