Provider Demographics
NPI:1528758703
Name:AFFABLE GROUP ADULT FOSTER CARE, LLC
Entity type:Organization
Organization Name:AFFABLE GROUP ADULT FOSTER CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VIKTORIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILKOMIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-953-4761
Mailing Address - Street 1:189 WELLS AVE STE 201A
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-3355
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:189 WELLS AVE STE 201A
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-3355
Practice Address - Country:US
Practice Address - Phone:617-953-4761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health