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General NPI Number Information
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NPI Number | 1144928854
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Entity Type | Organization
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Legal Business Name | AFFINITY HEALTHCARE, INC.
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Dates
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Enumeration Date | 02/21/2023
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 93 EAST 200 SOUTH SUITE 210-B
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City | LOGAN
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State | UT
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Zip | 84321
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Country | US
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Telephone | 435-276-0888
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Fax | 833-471-4536
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Provider Business Mailing Address
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Address Line | 2380 N 400 E STE B
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City | NORTH LOGAN
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State | UT
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Zip | 84341-1756
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Country | US
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Telephone | 435-276-0888
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LAVAL B JENSEN
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Credential |
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Telephone | 435-276-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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