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NPI Code Detail

MEDICARE: AFFINITY BLOOM HEALTHCARE AGENCY INC

MEDICARE: AFFINITY BLOOM HEALTHCARE AGENCY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251F00000XHome Infusion Agency
2251G00000XCommunity Based Hospice Care Agency
3251J00000XNursing Care Agency
4253Z00000XIn Home Supportive Care Agency
5343900000XNon-emergency Medical Transport (VAN)
6385H00000XRespite Care
7251E00000XHome Health Agency

General Provider Information

NPI Number : 1417713496
Entity Type Code : Organization
Provider Name (Legal Business Name) : AFFINITY BLOOM HEALTHCARE AGENCY INC
Provider Business Mailing Address
First Line : 18570 GRAND RIVER AVE STE 100D
Second Line :
City : DETROIT
State : MI
Zip : 48223-2201
Country : US
Telephone Number : 313-566-3486
Fax Number :
Provider Business Practice Location Address
First Line : 18570 GRAND RIVER AVE STE 100D
Second Line :
City : DETROIT
State : MI
Zip : 48223-2201
Country : US
Telephone Number : 313-566-3486
Fax Number :
Authorized Official
Title or Position : CEO
Name : LATASHA IRENE BALDWIN
Credential :
Telephone Number : 313-566-3486
Provider Enumeration Date : 02/26/2024
Last Update Date : 02/26/2024

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Directions to “AFFINITY BLOOM HEALTHCARE AGENCY INC ” Practice Location

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