Healthcare Provider Details

I. General information

NPI: 1013147180
Provider Name (Legal Business Name): HEALTHSTAFF SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 07/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 ROY HUIE RD
RIVERDALE GA
30274-1963
US

IV. Provider business mailing address

PO BOX 152
LOVEJOY GA
30250-0152
US

V. Phone/Fax

Practice location:
  • Phone: 770-996-6226
  • Fax: 770-996-6223
Mailing address:
  • Phone: 770-996-6226
  • Fax: 770-996-6223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number031R0239
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number031R0239
License Number StateGA

VIII. Authorized Official

Name: MS. HAZEL ANGELA GILGEOURS
Title or Position: ADMINISTRATOR
Credential:
Phone: 770-996-6226