MEDICARE: AFFINITY HCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2	251S00000X	Community/Behavioral Health Agency		TX

General Provider Information

NPI Number	:	1568667657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFINITY HCS

Provider Business Mailing Address
First Line	:	6017 DARLINGHURST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77085-2813
Country	:	US
Telephone Number	:	832-208-2338
Fax Number	:

Provider Business Practice Location Address
First Line	:	6017 DARLINGHURST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77085-2813
Country	:	US
Telephone Number	:	832-208-2338
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DORIS J BROWN
Credential	:
Telephone Number	:	832-208-2338

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	06/19/2008

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