MEDICARE: AFFINITY CARE 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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1669171427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFINITY CARE LLC

Provider Business Mailing Address
First Line	:	9095 CABRERA COVE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-3226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 E BONANZA RD STE 160
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-3705
Country	:	US
Telephone Number	:	714-287-4827
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JENNECHIEL TALAID
Credential	:
Telephone Number	:	714-287-4827

Provider Enumeration Date	:	03/01/2023
Last Update Date	:	03/01/2023

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Directions to “AFFINITY CARE LLC ” Practice Location

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