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General NPI Number Information
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NPI Number | 1427414549
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Entity Type | Organization
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Legal Business Name | AFFINITY HEALTH GROUP, LLC
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 1000 JONESBORO RD BEVERAGE DIVISION PLANT 70
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City | WEST MONROE
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State | LA
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Zip | 71292-5925
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Country | US
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Telephone | 318-362-2099
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Fax | 318-362-2775
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Provider Business Mailing Address
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Address Line | 130 DESIARD ST SUITE 355
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City | MONROE
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State | LA
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Zip | 71201-7319
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Country | US
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Telephone | 318-807-7875
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Fax | 318-812-6603
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | JANET JUSTICE
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Credential |
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Telephone | 318-807-7875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number |
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License Number State |
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