Provider Demographics
NPI:1033470133
Name:AFFORDABLE CARE NW, LLC
Entity Type:Organization
Organization Name:AFFORDABLE CARE NW, LLC
Other - Org Name:HELPING HANDS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:FORSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-442-3990
Mailing Address - Street 1:3609 SE 144TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-2728
Mailing Address - Country:US
Mailing Address - Phone:503-253-8458
Mailing Address - Fax:503-257-0911
Practice Address - Street 1:3609 SE 144TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97236-2728
Practice Address - Country:US
Practice Address - Phone:503-253-8458
Practice Address - Fax:503-257-0911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-2249251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR15-2249OtherOREGON DEPARTMENT OF HUMAN SERVICES