Provider Demographics
NPI:1710406871
Name:AFYA HEALTHCARE GROUP LLC
Entity Type:Organization
Organization Name:AFYA HEALTHCARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:MUKUA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:240-437-6022
Mailing Address - Street 1:1619 K ST NW STE 300
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:202-540-9319
Practice Address - Street 1:1619 K ST NW STE 300
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1601
Practice Address - Country:US
Practice Address - Phone:202-540-9319
Practice Address - Fax:202-540-9319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-11
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No335G00000XSuppliersMedical Foods Supplier
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child