Provider Demographics
NPI:1861042780
Name:AFFECTIONATE HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:AFFECTIONATE HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TATYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRASHKEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-798-9855
Mailing Address - Street 1:5745B N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-2307
Mailing Address - Country:US
Mailing Address - Phone:215-798-9855
Mailing Address - Fax:215-224-6000
Practice Address - Street 1:5745B N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-2307
Practice Address - Country:US
Practice Address - Phone:215-798-9855
Practice Address - Fax:215-224-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health