Provider Demographics
NPI:1487014262
Name:AMERICAN UNIQUE STAFF PROVIDER
Entity Type:Organization
Organization Name:AMERICAN UNIQUE STAFF PROVIDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:BROWN
Authorized Official - Last Name:EZEUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-445-3515
Mailing Address - Street 1:8761 DE SOTO AVE
Mailing Address - Street 2:SUITE 127
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304
Mailing Address - Country:US
Mailing Address - Phone:818-445-3515
Mailing Address - Fax:
Practice Address - Street 1:8761 DE SOTO AVE
Practice Address - Street 2:SUITE 127
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304
Practice Address - Country:US
Practice Address - Phone:818-445-3515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health