Provider Demographics
NPI:1134492127
Name:AFFINITY NURSING SERVICES
Entity Type:Organization
Organization Name:AFFINITY NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-346-4180
Mailing Address - Street 1:4141 NORTHGATE BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1231
Mailing Address - Country:US
Mailing Address - Phone:916-346-4180
Mailing Address - Fax:
Practice Address - Street 1:4141 NORTHGATE BLVD STE 6
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1231
Practice Address - Country:US
Practice Address - Phone:916-346-4180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3191223251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care