Provider Demographics
NPI:1558844464
Name:PAMELA COLLETT
Entity Type:Organization
Organization Name:PAMELA COLLETT
Other - Org Name:RESIDENTIAL SUPPORT SERVICES CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATIKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-674-9857
Mailing Address - Street 1:865 91ST AVE N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-2426
Mailing Address - Country:US
Mailing Address - Phone:239-591-5010
Mailing Address - Fax:
Practice Address - Street 1:865 91ST AVE N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-2426
Practice Address - Country:US
Practice Address - Phone:239-591-5010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty