Provider Demographics
NPI:1629286562
Name:HOME CARE SERVICE STAFFING INC.
Entity Type:Organization
Organization Name:HOME CARE SERVICE STAFFING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DYKHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-454-9844
Mailing Address - Street 1:1077 LEONARD ST NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-1261
Mailing Address - Country:US
Mailing Address - Phone:616-454-9844
Mailing Address - Fax:
Practice Address - Street 1:1077 LEONARD ST NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-1261
Practice Address - Country:US
Practice Address - Phone:616-454-9844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health