Healthcare Provider Details

I. General information

NPI: 1669171427
Provider Name (Legal Business Name): AFFINITY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 E BONANZA RD STE 160
LAS VEGAS NV
89101-3705
US

IV. Provider business mailing address

9095 CABRERA COVE ST
LAS VEGAS NV
89178-3226
US

V. Phone/Fax

Practice location:
  • Phone: 714-287-4827
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNECHIEL TALAID
Title or Position: OWNER
Credential:
Phone: 714-287-4827