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NPI 1629203013

NPI 1629203013 : AFFECTIVE HEALTHCARE INC : ENCINO, CA

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General NPI Number Information
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    NPI Number           |    1629203013
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    Entity Type          |    Organization 
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    Legal Business Name  |    AFFECTIVE HEALTHCARE INC 
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Dates
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    Enumeration Date     |    05/28/2009
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    Last Update Date     |    05/28/2009
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Provider Practice Location Address
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    Address Line         |    16200 VENTURA BLVD STE 407 
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    City                 |    ENCINO
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    State                |    CA
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    Zip                  |    91436-4696
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    Country              |    US
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    Telephone            |    818-929-4970
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    Fax                  |    818-975-5230
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Provider Business Mailing Address
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    Address Line         |    16200 VENTURA BLVD STE 407 
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    City                 |    ENCINO
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    State                |    CA
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    Zip                  |    91436-4696
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    Country              |    US
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    Telephone            |    818-929-4970
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    Fax                  |    818-975-5230
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     JAYMIE LLOYD FELIPE 
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    Credential           |    
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    Telephone            |    818-929-4970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    253Z00000X
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    Taxonomy Name        |    In Home Supportive Care Agency
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    License Number       |    
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    License Number State |    
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