Provider Demographics
NPI:1639387392
Name:INTERIM HEALTHCARE STAFFING SERVICES INC
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE STAFFING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEOOWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-494-9444
Mailing Address - Street 1:2551 CONTINENTAL CT
Mailing Address - Street 2:STE 2
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-6090
Mailing Address - Country:US
Mailing Address - Phone:920-494-9444
Mailing Address - Fax:
Practice Address - Street 1:2551 CONTINENTAL CT
Practice Address - Street 2:STE 2
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-6090
Practice Address - Country:US
Practice Address - Phone:920-494-9444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI266251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41529300Medicaid
WI41529300Medicaid