Provider Demographics
NPI:1114128121
Name:HEALTHCARE STAFFERS, LLC
Entity Type:Organization
Organization Name:HEALTHCARE STAFFERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:F
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-586-7147
Mailing Address - Street 1:545 MAINSTREAM DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1213
Mailing Address - Country:US
Mailing Address - Phone:615-259-2772
Mailing Address - Fax:
Practice Address - Street 1:545 MAINSTREAM DR STE 100
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1213
Practice Address - Country:US
Practice Address - Phone:615-259-2772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL 438-017-3683385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNL 438-017-3683OtherSTATE LICENSE NUMBER
TN=========Medicare UPIN