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General NPI Number Information
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NPI Number | 1154636074
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Entity Type | Organization
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Legal Business Name | EXPRESS MEDICAL STAFFING, INC.
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Dates
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Enumeration Date | 08/16/2010
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 228 RISER ST
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City | COLUMBIA
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State | LA
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Zip | 71418-4335
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Country | US
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Telephone | 318-649-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 8475 HIGHWAY 165
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City | COLUMBIA
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State | LA
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Zip | 71418-4335
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Country | US
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Telephone | 318-649-3200
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | REBA BRISCOE
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Credential | RN
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Telephone | 318-649-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 8489
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License Number State | LA
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