Healthcare Provider Details

I. General information

NPI: 1407136708
Provider Name (Legal Business Name): THERAPY STAFF SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2011
Last Update Date: 02/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 W PEARL ST
JACKSON MS
39203-2841
US

IV. Provider business mailing address

1060 E COUNTY LINE RD SUITE 3A-201
RIDGELAND MS
39157-4402
US

V. Phone/Fax

Practice location:
  • Phone: 601-960-5329
  • Fax:
Mailing address:
  • Phone: 601-714-2820
  • Fax: 210-587-6529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberR857627
License Number StateMS

VIII. Authorized Official

Name: MRS. ERIN SHIRLEY
Title or Position: DIRECTOR OF STAFFING SERVICES
Credential:
Phone: 601-714-2820