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Affinia Healthcare

Organization Active NPI Federally Qualified Health Center (FQHC) · Saint Louis, MO

NPI 1871069062 · NPPES record last updated Oct 16, 2018

Key facts

NPI
1871069062
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
AFFINIA HEALTHCARE
Practice address
1731 S Broadway
Saint Louis, MO 63104-4050
Phone
(314) 814-8700
Fax
(314) 814-8542
NPI assigned
Oct 16, 2018
Organization subpart
No

Authorized official

Name
Corinthia Darcel Jamison
Title
Credentialing Coordinator
Phone
(314) 814-8531

Corporate family (same tax ID) 20

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Affinia Healthcare (21 organizations share this tax ID)

Locations

1731 S Broadway
Saint Louis, MO 63104
Phone (314) 231-2337

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

1731 S Broadway
Saint Louis, MO 63104-4050

Mailing address

PO Box 551
Saint Louis, MO 63188-0551
Phone (314) 814-8531

Other names

  • Lift for Life Academy Doing business as

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Federally Qualified Health Center (FQHC) in Missouri

Sources for this page

Verify at the official NPI Registry.