Provider Demographics
NPI:1730461013
Name:AFFINITY HOME CARE, INC
Entity Type:Organization
Organization Name:AFFINITY HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-336-3300
Mailing Address - Street 1:PO BOX 1215
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:LA
Mailing Address - Zip Code:71373-1215
Mailing Address - Country:US
Mailing Address - Phone:318-336-3300
Mailing Address - Fax:318-336-9005
Practice Address - Street 1:205 CARTER ST
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:LA
Practice Address - Zip Code:71373-3303
Practice Address - Country:US
Practice Address - Phone:318-336-3300
Practice Address - Fax:318-336-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA 15521253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care