Provider Demographics
NPI:1760510358
Name:STAFF ONE, LTD.
Entity Type:Organization
Organization Name:STAFF ONE, LTD.
Other - Org Name:STAFF ONE HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-302-9170
Mailing Address - Street 1:6737 W WASHINGTON ST
Mailing Address - Street 2:SUITE 2120
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-5647
Mailing Address - Country:US
Mailing Address - Phone:414-302-9170
Mailing Address - Fax:414-302-9175
Practice Address - Street 1:6737 W WASHINGTON ST
Practice Address - Street 2:SUITE 2120
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-5647
Practice Address - Country:US
Practice Address - Phone:414-302-9170
Practice Address - Fax:414-302-9175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1076251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health