Provider Demographics
NPI:1467958686
Name:AFFINITY CARE HOME CARE LLC
Entity Type:Organization
Organization Name:AFFINITY CARE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MA
Authorized Official - Phone:240-665-0727
Mailing Address - Street 1:15954 ALAMEDA DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1332
Mailing Address - Country:US
Mailing Address - Phone:240-665-0727
Mailing Address - Fax:301-572-6858
Practice Address - Street 1:15954 ALAMEDA DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1332
Practice Address - Country:US
Practice Address - Phone:240-665-0727
Practice Address - Fax:301-572-6858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR4181251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health