Provider Demographics
NPI:1033668975
Name:AFFROCARE SERVICES, INC
Entity Type:Organization
Organization Name:AFFROCARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY GENERAL
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:F
Authorized Official - Last Name:SEWOYEBA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:651-592-6614
Mailing Address - Street 1:2488 BELMONT LN E
Mailing Address - Street 2:
Mailing Address - City:NORTH SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55109-4083
Mailing Address - Country:US
Mailing Address - Phone:651-592-6614
Mailing Address - Fax:
Practice Address - Street 1:2488 BELMONT LN E
Practice Address - Street 2:
Practice Address - City:NORTH SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55109-4083
Practice Address - Country:US
Practice Address - Phone:651-592-6614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN212291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty