Provider Demographics
NPI:1467008169
Name:STAFF ON DEMAND
Entity Type:Organization
Organization Name:STAFF ON DEMAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARENETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-588-0729
Mailing Address - Street 1:21109 NW COUNTY ROAD 235A
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-4232
Mailing Address - Country:US
Mailing Address - Phone:386-588-0729
Mailing Address - Fax:
Practice Address - Street 1:3131 NW 13TH ST STE 51
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-2183
Practice Address - Country:US
Practice Address - Phone:386-588-0729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-18
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty