Affinity Health Management LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

AS800237410 Issued in MI

Legal business name

AFFINITY HEALTH MANAGEMENT LLC

Practice address

48288 22ND St
Mattawan, MI 49071-9723

Phone

(269) 668-2143

Fax

(269) 668-4613

NPI assigned

Apr 11, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Lynn Eric Geresy

Title

President

Phone

(269) 668-2143

Specialties & licenses 2

Addresses

Other names 1

• Cornerhouse LLC Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1134583610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 438",
            "city": "OSHTEMO",
            "state": "MI",
            "postal_code": "490770438",
            "telephone_number": "269-668-2143",
            "fax_number": "269-668-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48288 22ND ST",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490719723",
            "telephone_number": "269-668-2143",
            "fax_number": "269-668-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINITY HEALTH MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "GERESY",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-668-2143",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MI",
            "license": "AS800237410",
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MI",
            "license": "AS030369567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerhouse LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Adult Care Home Facility in Mattawan, MI
• Providers in Mattawan, MI by specialty
• Adult Care Home Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.