Provider Demographics
NPI:1154772796
Name:AFFINITY GUIDANCE SERVICES INC
Entity type:Organization
Organization Name:AFFINITY GUIDANCE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEUFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-830-6945
Mailing Address - Street 1:1971 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-1012
Mailing Address - Country:US
Mailing Address - Phone:435-830-6945
Mailing Address - Fax:435-578-0700
Practice Address - Street 1:1971 N STATE ST
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-1012
Practice Address - Country:US
Practice Address - Phone:435-830-6945
Practice Address - Fax:435-578-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT21366320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness