Provider Demographics
NPI:1659760411
Name:AFFINITY GUIDANCE SERVICES, INC
Entity Type:Organization
Organization Name:AFFINITY GUIDANCE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:JACKSON
Authorized Official - Last Name:NEUFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-200-2471
Mailing Address - Street 1:1971 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-1012
Mailing Address - Country:US
Mailing Address - Phone:855-200-2471
Mailing Address - Fax:435-578-0700
Practice Address - Street 1:1971 N STATE ST
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-1012
Practice Address - Country:US
Practice Address - Phone:855-200-2471
Practice Address - Fax:435-578-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-16
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10870101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty