Provider Demographics
NPI:1952514564
Name:AFFINITY FAMILY CARE, LLC.
Entity Type:Organization
Organization Name:AFFINITY FAMILY CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-558-3600
Mailing Address - Street 1:PO BOX 1865
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85299-1865
Mailing Address - Country:US
Mailing Address - Phone:480-558-3600
Mailing Address - Fax:480-558-1806
Practice Address - Street 1:1423 S HIGLEY RD
Practice Address - Street 2:SUITE #115
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3429
Practice Address - Country:US
Practice Address - Phone:480-558-3600
Practice Address - Fax:480-558-1806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ953689251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health