Provider Demographics
NPI:1639373178
Name:SUPPORT STAFF, INC.
Entity Type:Organization
Organization Name:SUPPORT STAFF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLEY
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:JEGBADAI
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:919-790-1953
Mailing Address - Street 1:600 S MAGNOLIA AVE
Mailing Address - Street 2:SU9ITE 104-B
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-5825
Mailing Address - Country:US
Mailing Address - Phone:910-230-0222
Mailing Address - Fax:910-230-0333
Practice Address - Street 1:600 S MAGNOLIA AVE
Practice Address - Street 2:SU9ITE 104-B
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-5825
Practice Address - Country:US
Practice Address - Phone:910-230-0222
Practice Address - Fax:910-230-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health