Provider Demographics
NPI:1023482502
Name:AFFINITY HOME HEALTH CARE
Entity type:Organization
Organization Name:AFFINITY HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEIGH-ANNE
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:720-340-4865
Mailing Address - Street 1:4501 NELSON RD UNIT 2203
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-9433
Mailing Address - Country:US
Mailing Address - Phone:720-340-4865
Mailing Address - Fax:720-340-4865
Practice Address - Street 1:4501 NELSON RD UNIT 2203
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-9433
Practice Address - Country:US
Practice Address - Phone:720-340-4865
Practice Address - Fax:720-340-4865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1628627251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health