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General NPI Number Information
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NPI Number | 1548817620
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Entity Type | Organization
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Legal Business Name | AFFINITY RESIDENTIAL CARE LLC
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 8053 E BLOOMINGTON FWY STE 500
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City | BLOOMINGTON
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State | MN
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Zip | 55420-1003
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Country | US
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Telephone | 952-217-4750
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Fax | 612-930-0108
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Provider Business Mailing Address
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Address Line | 8053 E BLOOMINGTON FWY STE 500
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City | BLOOMINGTON
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State | MN
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Zip | 55420-1003
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Country | US
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Telephone | 612-386-0942
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Fax | 612-930-0108
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Authorized Official
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Title or Position | OWNER
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Name | ZAHNIA AMINAH HARUT
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Credential | RN
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Telephone | 612-386-0942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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