Provider Demographics
NPI:1851017016
Name:AFFECTIONATE HOME CARE INC.
Entity Type:Organization
Organization Name:AFFECTIONATE HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:KWABLAH
Authorized Official - Last Name:BUKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-808-1309
Mailing Address - Street 1:13 MELVILLE ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-6408
Mailing Address - Country:US
Mailing Address - Phone:203-808-1309
Mailing Address - Fax:
Practice Address - Street 1:13 MELVILLE ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-6408
Practice Address - Country:US
Practice Address - Phone:203-808-1309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty