MEDICARE: DALLASSTAFFLINK

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	251E00000X	Home Health Agency	010244	TX

General Provider Information

NPI Number	:	1376738682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLASSTAFFLINK

Provider Business Mailing Address
First Line	:	2626 DEEP HILL CIR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75233-4006
Country	:	US
Telephone Number	:	214-331-8721
Fax Number	:	214-331-6950

Provider Business Practice Location Address
First Line	:	2626 DEEP HILL CIR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75233-4006
Country	:	US
Telephone Number	:	214-331-8721
Fax Number	:	214-331-6950

Authorized Official
Title or Position	:	CHIEF NURSING OFFICER
Name	:	SUE MARCO
Credential	:	RN , BSN, M.A.
Telephone Number	:	214-331-6944

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	09/10/2007

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