Healthcare Provider Details

I. General information

NPI: 1114128121
Provider Name (Legal Business Name): HEALTHCARE STAFFERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 05/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 MAINSTREAM DR STE 100
NASHVILLE TN
37228-1213
US

IV. Provider business mailing address

545 MAINSTREAM DR STE 100
NASHVILLE TN
37228-1213
US

V. Phone/Fax

Practice location:
  • Phone: 615-259-2772
  • Fax:
Mailing address:
  • Phone: 615-259-2772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License NumberL 438-017-3683
License Number StateTN

VIII. Authorized Official

Name: MR. BOB F DONOVAN
Title or Position: PRESIDENT
Credential:
Phone: 503-586-7147