Provider Demographics
NPI:1063788198
Name:AFFORDABLE PERSONAL CARE
Entity type:Organization
Organization Name:AFFORDABLE PERSONAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-943-8735
Mailing Address - Street 1:12530 IRON BRIDGE RD
Mailing Address - Street 2:L
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1599
Mailing Address - Country:US
Mailing Address - Phone:804-715-4990
Mailing Address - Fax:800-841-1623
Practice Address - Street 1:12530 IRON BRIDGE RD
Practice Address - Street 2:L
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1599
Practice Address - Country:US
Practice Address - Phone:804-715-4990
Practice Address - Fax:800-841-1623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health