Provider Demographics
NPI:1881280071
Name:BATAVIAS NURSING AFFINITY LLC BATAVIAS NURSING AFFINITY
Entity type:Organization
Organization Name:BATAVIAS NURSING AFFINITY LLC BATAVIAS NURSING AFFINITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BATAVIA
Authorized Official - Middle Name:ANTONETTE
Authorized Official - Last Name:GILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-784-0506
Mailing Address - Street 1:14765 GALLANT LN
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-5516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14765 GALLANT LN
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-5516
Practice Address - Country:US
Practice Address - Phone:240-784-0506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-12
Last Update Date:2020-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health