Provider Demographics
NPI:1477849032
Name:DIVERSIFIED STAFFING
Entity Type:Organization
Organization Name:DIVERSIFIED STAFFING
Other - Org Name:WORCESTER STATE HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:AREA DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:COMFORTI
Authorized Official - Suffix:
Authorized Official - Credentials:AREA DIRECTOR
Authorized Official - Phone:508-459-6196
Mailing Address - Street 1:39 SALISBURY STREET
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609
Mailing Address - Country:US
Mailing Address - Phone:508-459-6196
Mailing Address - Fax:508-755-8833
Practice Address - Street 1:39 SALISBURY STREET
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609
Practice Address - Country:US
Practice Address - Phone:508-459-6196
Practice Address - Fax:508-755-8833
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0808YBMedicaid