Affinity Health Care LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

11322 Issued in WI

Legal business name

AFFINITY HEALTH CARE LLC

Practice address

8208 Racine Ave
Wind Lake, WI 53185-1440

Phone

(262) 895-3052

Fax

(262) 895-6673

NPI assigned

Feb 9, 2007

Last updated

Nov 12, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas R Schilling

Title

Owner

Phone

(262) 895-3052

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194825600000",
    "number": "1265573695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8208 RACINE AVE",
            "city": "WIND LAKE",
            "state": "WI",
            "postal_code": "531851440",
            "telephone_number": "262-895-3052",
            "fax_number": "262-895-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8208 RACINE AVE",
            "city": "WIND LAKE",
            "state": "WI",
            "postal_code": "531851440",
            "telephone_number": "262-895-3052",
            "fax_number": "262-895-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINITY HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-11-12",
        "status": "A",
        "authorized_official_last_name": "SCHILLING",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-895-3052"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "WI",
            "license": "11322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Affinity Health Care LLC
• Kimberly Banach
• Amy L Bluhm
• Erik R Burtraw, COTA
• Leah C. Clemence, R.N.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wind Lake, WI
• Providers in Wind Lake, WI by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; 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.