Provider Demographics
NPI:1609119080
Name:AFFINITY HOSPICE, LLC
Entity Type:Organization
Organization Name:AFFINITY HOSPICE, LLC
Other - Org Name:AFFINITY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AUTHEMENT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:936-639-2626
Mailing Address - Street 1:2708 S MEDFORD DR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-6122
Mailing Address - Country:US
Mailing Address - Phone:936-639-2626
Mailing Address - Fax:936-639-2629
Practice Address - Street 1:2708 S MEDFORD DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-6122
Practice Address - Country:US
Practice Address - Phone:936-639-2626
Practice Address - Fax:936-639-2629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013942251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health