Healthcare Provider Details

I. General information

NPI: 1326364597
Provider Name (Legal Business Name): AFFORDABLE HOME CARE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 03/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1257 ESLAVA LN
MOBILE AL
36605-2352
US

IV. Provider business mailing address

P. O. BOX 50445 1257 ESLAVA LN
MOBILE AL
36605-2352
US

V. Phone/Fax

Practice location:
  • Phone: 251-643-6382
  • Fax: 251-607-6371
Mailing address:
  • Phone: 251-643-6382
  • Fax: 251-607-6371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number089079
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number089079
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number089079
License Number StateAL

VIII. Authorized Official

Name: MRS. ANTIONETTE MCCARROLL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 251-643-6382