Provider Demographics
NPI:1548560113
Name:HGM STAFFING, L.L.C.
Entity Type:Organization
Organization Name:HGM STAFFING, L.L.C.
Other - Org Name:HANDS OF GRACE MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / CEO; ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLENDINA
Authorized Official - Middle Name:HARRIET
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MBA
Authorized Official - Phone:832-369-2811
Mailing Address - Street 1:13100 WORTHAM CENTER DR
Mailing Address - Street 2:SUITE #275
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-5625
Mailing Address - Country:US
Mailing Address - Phone:832-369-2811
Mailing Address - Fax:832-213-0127
Practice Address - Street 1:13100 WORTHAM CENTER DR
Practice Address - Street 2:SUITE #275
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-5625
Practice Address - Country:US
Practice Address - Phone:832-369-2811
Practice Address - Fax:832-213-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013835251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX013835OtherTX DADS HOME AND COMMUNITY SUPPORT AGENCY LICENSE ( LHHS & PAS)