Provider Demographics
NPI:1760136840
Name:AFFINITY HEALTHCARE VENTURA, INC.
Entity Type:Organization
Organization Name:AFFINITY HEALTHCARE VENTURA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONI
Authorized Official - Middle Name:
Authorized Official - Last Name:EAPEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-655-8457
Mailing Address - Street 1:310 S WELLS RD STE 207A
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-1356
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:626-655-8456
Practice Address - Street 1:310 S WELLS RD STE 207A
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004-1356
Practice Address - Country:US
Practice Address - Phone:626-655-8457
Practice Address - Fax:626-655-8456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health