Provider Demographics
NPI:1346799350
Name:PROVIDENCE STAFFING AGENCY
Entity Type:Organization
Organization Name:PROVIDENCE STAFFING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAW
Authorized Official - Middle Name:
Authorized Official - Last Name:AKO-ASARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-560-4411
Mailing Address - Street 1:2 PROFESSIONAL DR
Mailing Address - Street 2:STE 241
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3408
Mailing Address - Country:US
Mailing Address - Phone:301-560-4411
Mailing Address - Fax:
Practice Address - Street 1:2 PROFESSIONAL DR
Practice Address - Street 2:STE 241
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3408
Practice Address - Country:US
Practice Address - Phone:301-560-4411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health