Provider Demographics
NPI:1063925683
Name:AFFINITY GROUP, LLC
Entity type:Organization
Organization Name:AFFINITY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:ATINIZIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:339-293-9066
Mailing Address - Street 1:620 NEW PART CENTER DRIVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:714-948-6086
Mailing Address - Fax:714-722-0112
Practice Address - Street 1:13340 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-6444
Practice Address - Country:US
Practice Address - Phone:949-501-5979
Practice Address - Fax:714-722-0112
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AFFINITY GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-06
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility