Provider Demographics
NPI:1205007507
Name:AFFABLE HOME CARE, INC.
Entity Type:Organization
Organization Name:AFFABLE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAROUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-850-9444
Mailing Address - Street 1:1674 BROADWAY STE 502
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5858
Mailing Address - Country:US
Mailing Address - Phone:718-850-9444
Mailing Address - Fax:212-608-2901
Practice Address - Street 1:1674 BROADWAY STE 502
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5858
Practice Address - Country:US
Practice Address - Phone:718-850-9444
Practice Address - Fax:212-608-2901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9899L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01957377Medicaid