Provider Demographics
NPI:1831304419
Name:QUICKSTAFF HEALTHCARE INC
Entity Type:Organization
Organization Name:QUICKSTAFF HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KESSINGTON
Authorized Official - Middle Name:
Authorized Official - Last Name:OKUNDAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-357-4755
Mailing Address - Street 1:40 N CENTRAL AVE
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-4424
Mailing Address - Country:US
Mailing Address - Phone:602-357-4755
Mailing Address - Fax:602-391-2272
Practice Address - Street 1:40 N CENTRAL AVE
Practice Address - Street 2:SUITE 1400
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-4424
Practice Address - Country:US
Practice Address - Phone:602-357-4755
Practice Address - Fax:602-391-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA3927251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZHHA3927OtherHOME HEALTH AGENCY ID
AZ098657OtherAHCCCS PROVIDER ID