Provider Demographics
NPI:1205452315
Name:AFFECTION HEALTHCARE LLC
Entity type:Organization
Organization Name:AFFECTION HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMAECHI
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:OZOR
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:714-654-4206
Mailing Address - Street 1:1641 N RIPON RD APT 306
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:CA
Mailing Address - Zip Code:95366-9817
Mailing Address - Country:US
Mailing Address - Phone:714-654-4206
Mailing Address - Fax:
Practice Address - Street 1:1641 NORTH RIPON ROAD
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:CA
Practice Address - Zip Code:95366
Practice Address - Country:US
Practice Address - Phone:307-274-4066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service