Provider Demographics
NPI: | 1760889034 |
---|---|
Name: | MAS MEDICAL STAFFING |
Entity Type: | Organization |
Organization Name: | MAS MEDICAL STAFFING |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | QUALITY ASSURANCE SPECIALIST |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | KATHRINE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WOODMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 800-657-6517 |
Mailing Address - Street 1: | 156 HARVEY RD |
Mailing Address - Street 2: | |
Mailing Address - City: | LONDONDERRY |
Mailing Address - State: | NH |
Mailing Address - Zip Code: | 03053-7449 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 800-657-6517 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 510 CENTENNIAL CIR |
Practice Address - Street 2: | |
Practice Address - City: | NORTH PLATTE |
Practice Address - State: | NE |
Practice Address - Zip Code: | 69101-6586 |
Practice Address - Country: | US |
Practice Address - Phone: | 308-534-7000 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-12-02 |
Last Update Date: | 2014-12-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NE | 1355 | 320700000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities |