Provider Demographics
NPI:1871329268
Name:AFFLUENCE CARE LLC
Entity type:Organization
Organization Name:AFFLUENCE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED NURSE
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LESHOURE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:309-428-1150
Mailing Address - Street 1:1619 JUDSON ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-3329
Mailing Address - Country:US
Mailing Address - Phone:309-428-1150
Mailing Address - Fax:
Practice Address - Street 1:4620 E 53RD ST STE 200
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3627
Practice Address - Country:US
Practice Address - Phone:563-343-4176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health