Provider Demographics
NPI:1437301751
Name:AFFINITY HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:AFFINITY HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:C
Authorized Official - Last Name:DELOS REYES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:708-867-7902
Mailing Address - Street 1:7151 W GUNNISON ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HARWOOD HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60706-3800
Mailing Address - Country:US
Mailing Address - Phone:708-867-7902
Mailing Address - Fax:708-867-7952
Practice Address - Street 1:7151 W GUNNISON ST
Practice Address - Street 2:SUITE 103
Practice Address - City:HARWOOD HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60706-3800
Practice Address - Country:US
Practice Address - Phone:708-867-7902
Practice Address - Fax:708-867-7952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010937251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health