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General NPI Number Information
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NPI Number | 1053056978
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Entity Type | Organization
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Legal Business Name | AFFINITY HOME CARE AGENCY, INC.
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Dates
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Enumeration Date | 05/04/2022
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 100 S ASHLEY DR STE 600
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City | TAMPA
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State | FL
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Zip | 33602-5300
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Country | US
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Telephone | 850-765-5241
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Fax |
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Provider Business Mailing Address
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Address Line | 1584 METROPOLITAN BLVD STE 101
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City | TALLAHASSEE
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State | FL
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Zip | 32308-1701
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Country | US
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Telephone | 850-765-5241
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Fax | 360-933-2951
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Authorized Official
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Title or Position | REGIONAL DIRECTOR
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Name | MERLENE DELOIS JOHNSON
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Credential | MASTER OF EDUCATION
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Telephone | 850-765-5241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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