Provider Demographics
NPI:1710111968
Name:AFFINITY HEALTH CARE, LLC
Entity Type:Organization
Organization Name:AFFINITY HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARKNESS
Authorized Official - Suffix:
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:409-383-1400
Mailing Address - Fax:409-383-1401
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:409-383-1400
Practice Address - Fax:888-659-2676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-03
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747436Medicare UPIN