Provider Demographics
NPI:1467407205
Name:AFFINITY HOME CARE INC
Entity Type:Organization
Organization Name:AFFINITY HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SALEEM
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHAKOOR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:317-837-8272
Mailing Address - Street 1:10 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-1220
Mailing Address - Country:US
Mailing Address - Phone:317-837-8272
Mailing Address - Fax:317-837-8273
Practice Address - Street 1:10 S EAST ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-1220
Practice Address - Country:US
Practice Address - Phone:317-837-8272
Practice Address - Fax:317-837-8273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
IN070111291251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200838950AMedicaid
157582Medicare Oscar/Certification