Provider Demographics
NPI:1902231152
Name:AFFORDABLE CARE NW, LLC
Entity Type:Organization
Organization Name:AFFORDABLE CARE NW, LLC
Other - Org Name:HELPING HANDS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR / PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:TOBIAS
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:FORSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-239-8000
Mailing Address - Street 1:6901 SE LAKE RD STE 22
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97267-2112
Mailing Address - Country:US
Mailing Address - Phone:503-239-8000
Mailing Address - Fax:
Practice Address - Street 1:6901 SE LAKE RD STE 22
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97267-2112
Practice Address - Country:US
Practice Address - Phone:503-239-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-2249251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500659585Medicaid