Provider Demographics
NPI:1912290735
Name:AFYA HOME CARE LLC
Entity Type:Organization
Organization Name:AFYA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WANJIRU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:978-259-8202
Mailing Address - Street 1:439 S UNION ST
Mailing Address - Street 2:SUITE B12
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-2837
Mailing Address - Country:US
Mailing Address - Phone:978-258-7271
Mailing Address - Fax:978-258-2193
Practice Address - Street 1:439 S UNION ST
Practice Address - Street 2:SUITE B12
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-2837
Practice Address - Country:US
Practice Address - Phone:978-258-7271
Practice Address - Fax:978-258-2193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-26
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2263405251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health