Healthcare Provider Details

I. General information

NPI: 1164668042
Provider Name (Legal Business Name): HEALTHSTAA EMPLOYMENT SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2008
Last Update Date: 12/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4945 SCHAEFER RD
DEARBORN MI
48126-3251
US

IV. Provider business mailing address

439 S MAIN ST 160
ROCHESTER MI
48307-6704
US

V. Phone/Fax

Practice location:
  • Phone: 313-581-0744
  • Fax:
Mailing address:
  • Phone: 248-453-5172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License NumberL1179962
License Number StateMI

VIII. Authorized Official

Name: MRS. ANNALIZA THET
Title or Position: PRESIDENT
Credential:
Phone: 248-453-5172