Provider Demographics
NPI:1164574224
Name:PALM BEACH STAFFING INC
Entity Type:Organization
Organization Name:PALM BEACH STAFFING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-433-9666
Mailing Address - Street 1:1261 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5172
Mailing Address - Country:US
Mailing Address - Phone:561-433-9666
Mailing Address - Fax:561-433-9413
Practice Address - Street 1:1261 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5172
Practice Address - Country:US
Practice Address - Phone:561-433-9666
Practice Address - Fax:561-433-9413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA20896096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHHA20896096OtherHOME HEALTH AGENCY LIC #