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General NPI Number Information
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NPI Number | 1912290735
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Entity Type | Organization
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Legal Business Name | AFYA HOME CARE LLC
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Dates
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Enumeration Date | 05/26/2011
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 439 S UNION ST SUITE B12
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City | LAWRENCE
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State | MA
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Zip | 01843-2837
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Country | US
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Telephone | 978-258-7271
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Fax | 978-258-2193
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Provider Business Mailing Address
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Address Line | 439 S UNION ST SUITE B12
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City | LAWRENCE
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State | MA
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Zip | 01843-2837
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Country | US
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Telephone | 978-258-7271
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Fax | 978-258-2193
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN WANJIRU
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Credential | RN
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Telephone | 978-259-8202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | RN2263405
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License Number State | MA
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