Healthcare Provider Details

I. General information

NPI: 1629935945
Provider Name (Legal Business Name): AFFINITY CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9007 DEER STREAM DR
UPPER MARLBORO MD
20772-2539
US

IV. Provider business mailing address

9007 DEER STREAM DR
UPPER MARLBORO MD
20772-2539
US

V. Phone/Fax

Practice location:
  • Phone: 910-237-3307
  • Fax:
Mailing address:
  • Phone: 910-237-3307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: FIDELIS ATABONG
Title or Position: BOARD MEMBER
Credential:
Phone: 910-237-3307