Provider Demographics
NPI:1992194583
Name:AFFINITY HOME CARE INC.
Entity Type:Organization
Organization Name:AFFINITY HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-302-8398
Mailing Address - Street 1:PO BOX 1116
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33443-1116
Mailing Address - Country:US
Mailing Address - Phone:561-302-8398
Mailing Address - Fax:954-782-3643
Practice Address - Street 1:18425 NW 2ND AVE STE 401
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4525
Practice Address - Country:US
Practice Address - Phone:305-625-9299
Practice Address - Fax:305-705-2695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211725251E00000X, 251J00000X
253Z00000X, 3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101506400Medicaid
FL691471300Medicaid
FL30211725OtherAHCA LICENSE #