Provider Demographics
NPI:1164798047
Name:AFFINITY ADULT DAYCARE
Entity Type:Organization
Organization Name:AFFINITY ADULT DAYCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUMAS VERAGUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-759-0112
Mailing Address - Street 1:8540 BLUERIDGE
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64138-2959
Mailing Address - Country:US
Mailing Address - Phone:816-759-0112
Mailing Address - Fax:
Practice Address - Street 1:18813 E 25TH ST S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2467
Practice Address - Country:US
Practice Address - Phone:816-898-7529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care