Provider Demographics
NPI:1639884174
Name:AFFINITY CARE SERVICES
Entity type:Organization
Organization Name:AFFINITY CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDIRIZAK
Authorized Official - Middle Name:
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-310-0348
Mailing Address - Street 1:1405 LILAC DR N STE 160K
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4535
Mailing Address - Country:US
Mailing Address - Phone:612-310-0348
Mailing Address - Fax:612-844-0588
Practice Address - Street 1:1405 LILAC DR N STE 160K
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4535
Practice Address - Country:US
Practice Address - Phone:612-310-0348
Practice Address - Fax:612-844-0588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management