Provider Demographics
NPI:1003682527
Name:AFFINITY HOMECARE SERVICES
Entity Type:Organization
Organization Name:AFFINITY HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD NURSE
Authorized Official - Prefix:
Authorized Official - First Name:LATOSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:908-906-5502
Mailing Address - Street 1:257 LINDEN AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-4234
Mailing Address - Country:US
Mailing Address - Phone:908-906-5502
Mailing Address - Fax:
Practice Address - Street 1:257 LINDEN AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-4234
Practice Address - Country:US
Practice Address - Phone:908-906-5502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty