Provider Demographics
NPI:1023813946
Name:ORIGINS AFC LLC
Entity type:Organization
Organization Name:ORIGINS AFC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-282-1818
Mailing Address - Street 1:515 PROVIDENCE HWY STE 104
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-6817
Mailing Address - Country:US
Mailing Address - Phone:508-282-1818
Mailing Address - Fax:
Practice Address - Street 1:515 PROVIDENCE HWY STE 104
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-6817
Practice Address - Country:US
Practice Address - Phone:508-282-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency