Healthcare Provider Details

I. General information

NPI: 1811816283
Provider Name (Legal Business Name): AFFINITY SUPPORT COORDINATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 GENERAL PATTON AVE
MANDEVILLE LA
70471-8700
US

IV. Provider business mailing address

917 RAPATEL ST
MANDEVILLE LA
70448-4411
US

V. Phone/Fax

Practice location:
  • Phone: 985-238-1695
  • Fax: 985-200-7215
Mailing address:
  • Phone: 985-238-1695
  • Fax: 986-200-5021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: EVELYNE J NEEL
Title or Position: ADMINISTRATOR/OWNER
Credential:
Phone: 504-338-5516