Provider Demographics
NPI:1225358500
Name:PLATINUM SELECT STAFFING
Entity Type:Organization
Organization Name:PLATINUM SELECT STAFFING
Other - Org Name:AMN HEALTHCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:DELORES
Authorized Official - Last Name:DILWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:404-630-8188
Mailing Address - Street 1:1737 E FRANKFORD RD APT 1404
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5630
Mailing Address - Country:US
Mailing Address - Phone:404-630-8188
Mailing Address - Fax:
Practice Address - Street 1:1737 E FRANKFORD RD APT 1404
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5630
Practice Address - Country:US
Practice Address - Phone:404-630-8188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMN HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102217314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility