Provider Demographics
NPI:1669284717
Name:AFINNIECO
Entity type:Organization
Organization Name:AFINNIECO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:ARDRETTA
Authorized Official - Middle Name:KENYAE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:I
Authorized Official - Credentials:DSP CM
Authorized Official - Phone:405-762-2170
Mailing Address - Street 1:425 S TACOMA WAY
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-1207
Mailing Address - Country:US
Mailing Address - Phone:405-762-2170
Mailing Address - Fax:405-762-2170
Practice Address - Street 1:425 S TACOMA WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-1207
Practice Address - Country:US
Practice Address - Phone:405-762-2170
Practice Address - Fax:405-762-2170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty