Provider Demographics
NPI:1982087573
Name:AFFECTIONATE HEART COMMUNITY HEALTH SERVICES INC
Entity Type:Organization
Organization Name:AFFECTIONATE HEART COMMUNITY HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAZAK
Authorized Official - Middle Name:A
Authorized Official - Last Name:OKUNEYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-620-3253
Mailing Address - Street 1:19022 FIELD COTTAGE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3859
Mailing Address - Country:US
Mailing Address - Phone:281-620-3253
Mailing Address - Fax:
Practice Address - Street 1:19022 FIELD COTTAGE LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-3859
Practice Address - Country:US
Practice Address - Phone:281-620-3253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty