Provider Demographics
NPI:1104662451
Name:AFFECTION HOME CARE LLC
Entity type:Organization
Organization Name:AFFECTION HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GAELLE
Authorized Official - Middle Name:THIAM
Authorized Official - Last Name:DWOMOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-714-3133
Mailing Address - Street 1:101 N MARION ST STE 203
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1023
Mailing Address - Country:US
Mailing Address - Phone:312-714-3133
Mailing Address - Fax:
Practice Address - Street 1:101 N MARION ST STE 203
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1023
Practice Address - Country:US
Practice Address - Phone:312-714-3133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-06
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care