Provider Demographics
NPI:1497141600
Name:ALSSTATE MEDICAL STAFFING LLC
Entity Type:Organization
Organization Name:ALSSTATE MEDICAL STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BASTIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-404-7478
Mailing Address - Street 1:120 AMARAL ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-2227
Mailing Address - Country:US
Mailing Address - Phone:401-404-7478
Mailing Address - Fax:401-709-4302
Practice Address - Street 1:120 AMARAL ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-2227
Practice Address - Country:US
Practice Address - Phone:401-404-7478
Practice Address - Fax:401-709-4302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251J00000X
RINPA00119251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health