Provider Demographics
NPI:1851344717
Name:STAFF ASSISTANCE, INC.
Entity Type:Organization
Organization Name:STAFF ASSISTANCE, INC.
Other - Org Name:ASSISTED HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GERD
Authorized Official - Middle Name:F
Authorized Official - Last Name:KERSWILL
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:805-371-9988
Mailing Address - Street 1:468 PENNSFIELD PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5570
Mailing Address - Country:US
Mailing Address - Phone:805-371-9988
Mailing Address - Fax:805-371-9987
Practice Address - Street 1:1900 W GARVEY AVE S
Practice Address - Street 2:SUITE 210
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2655
Practice Address - Country:US
Practice Address - Phone:626-915-5595
Practice Address - Fax:626-974-0136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001303251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA07292FMedicaid
CAHHA07292FMedicaid