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General NPI Number Information
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NPI Number | 1215066287
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Entity Type | Organization
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Legal Business Name | AFFINITY
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 400 RIVERSIDE ST UNIT A4
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City | PORTLAND
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State | ME
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Zip | 04103-1068
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Country | US
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Telephone | 207-747-1651
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Fax | 207-747-4745
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Provider Business Mailing Address
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Address Line | 400 RIVERSIDE ST UNIT A4
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City | PORTLAND
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State | ME
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Zip | 04103-1068
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Country | US
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Telephone | 207-747-1651
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Fax | 207-747-4745
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DANIEL CHAIMOWITZ
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Credential |
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Telephone | 207-747-1651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 0
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License Number State | ME
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