MEDICARE: TOTAL HEALTHCARE STAFFING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	04J542	CO
2	251E00000X	Home Health Agency	04J542	CO

General Provider Information

NPI Number	:	1033376199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL HEALTHCARE STAFFING, INC.

Provider Business Mailing Address
First Line	:	1902 E BOULDER ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-5839
Country	:	US
Telephone Number	:	719-634-4999
Fax Number	:	719-634-4978

Provider Business Practice Location Address
First Line	:	1902 E BOULDER ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-5839
Country	:	US
Telephone Number	:	719-634-4999
Fax Number	:	719-634-4978

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARK TERRY
Credential	:
Telephone Number	:	719-634-4999

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	08/05/2016

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