Provider Demographics
NPI:1558118869
Name:AFFINITY GROUP LLC
Entity type:Organization
Organization Name:AFFINITY GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
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 NEWPORT 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:949-933-7608
Mailing Address - Fax:
Practice Address - Street 1:68061 CALLE AZTECA
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240
Practice Address - Country:US
Practice Address - Phone:760-671-7989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility