Healthcare Provider Details

I. General information

NPI: 1497083273
Provider Name (Legal Business Name): SUNBELT STAFFING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2009
Last Update Date: 12/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14333 PHILIPPINE ST APT 1309
HOUSTON TX
77040-6919
US

IV. Provider business mailing address

14333 PHILIPPINE ST APT 1309
HOUSTON TX
77040-6919
US

V. Phone/Fax

Practice location:
  • Phone: 283-617-7065
  • Fax:
Mailing address:
  • Phone: 283-617-7065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number105007
License Number StateTX

VIII. Authorized Official

Name: MS. ANNA LAFLEUR
Title or Position: CREDENTIALING DEPARTMENT
Credential:
Phone: 866-568-9068