MEDICARE: AFFINITY HOME HEALTH SERVICES, LLC.

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
1	251E00000X	Home Health Agency	253334	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	253334	OTHER	NV	NEVADA STATE BUSINESS LIC

General Provider Information

NPI Number	:	1528011707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFINITY HOME HEALTH SERVICES, LLC.

Provider Business Mailing Address
First Line	:	2721 E RUSSELL RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-2426
Country	:	US
Telephone Number	:	702-933-1936
Fax Number	:	702-946-6670

Provider Business Practice Location Address
First Line	:	2721 E RUSSELL RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-2426
Country	:	US
Telephone Number	:	702-933-1936
Fax Number	:	702-946-6670

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	MRS. ISABEL TCRUZ
Credential	:
Telephone Number	:	702-933-1936

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	06/19/2012

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