Provider Demographics
NPI:1053936930
Name:AFFIRM HOMECARE SERVICES
Entity type:Organization
Organization Name:AFFIRM HOMECARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHINAZOR
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-712-9322
Mailing Address - Street 1:3723 GLEN LYON DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-1003
Mailing Address - Country:US
Mailing Address - Phone:704-712-9322
Mailing Address - Fax:
Practice Address - Street 1:3723 GLEN LYON DR
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-1003
Practice Address - Country:US
Practice Address - Phone:704-712-9322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care