Provider Demographics
NPI:1518273895
Name:AFFECTIONATE CARE SERVICE LLC
Entity Type:Organization
Organization Name:AFFECTIONATE CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-365-9543
Mailing Address - Street 1:7846 STEPHENSON DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-2748
Mailing Address - Country:US
Mailing Address - Phone:904-365-9543
Mailing Address - Fax:
Practice Address - Street 1:7846 STEPHENSON DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-2748
Practice Address - Country:US
Practice Address - Phone:904-365-9543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL693015896251E00000X
FL693015898253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care