Provider Demographics
NPI:1780450734
Name:AFRA HOME PLLC
Entity type:Organization
Organization Name:AFRA HOME PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KWASI
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-686-3726
Mailing Address - Street 1:905 W SPROUL RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-1254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:905 W SPROUL RD STE 106
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-1254
Practice Address - Country:US
Practice Address - Phone:617-686-3726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty