MEDICARE: AFFINITY PERSONAL CARE 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
1	253Z00000X	In Home Supportive Care Agency	000253231600014	CA

General Provider Information

NPI Number	:	1538462023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFINITY PERSONAL CARE AGENCY INC

Provider Business Mailing Address
First Line	:	18017 CHATSWORTH ST STE 418
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-5608
Country	:	US
Telephone Number	:	818-746-2667
Fax Number	:	818-746-2667

Provider Business Practice Location Address
First Line	:	18341 SHERMAN WAY STE 204
Second Line	:
City	:	RESEDA
State	:	CA
Zip	:	91335-4437
Country	:	US
Telephone Number	:	818-746-2667
Fax Number	:	818-746-2667

Authorized Official
Title or Position	:	CEOPRESIDENT
Name	:	SHEILA ABRAM
Credential	:
Telephone Number	:	818-746-2667

Provider Enumeration Date	:	12/06/2010
Last Update Date	:	02/01/2013

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