Provider Demographics
NPI:1881392090
Name:AFFECTIONATE HOME HEALTH, INC.
Entity type:Organization
Organization Name:AFFECTIONATE HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:PACIA
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:657-399-1142
Mailing Address - Street 1:1940 W ORANGEWOOD AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2065
Mailing Address - Country:US
Mailing Address - Phone:657-399-1142
Mailing Address - Fax:714-451-7934
Practice Address - Street 1:1940 W ORANGEWOOD AVE STE 202
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2065
Practice Address - Country:US
Practice Address - Phone:657-399-1142
Practice Address - Fax:714-451-7934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health