Provider Demographics
NPI:1891040754
Name:FAVORITE HEALTH CARE STAFFING
Entity Type:Organization
Organization Name:FAVORITE HEALTH CARE STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:612-499-0200
Mailing Address - Street 1:212 CHURCH ST S
Mailing Address - Street 2:PO BOX 184
Mailing Address - City:BROWNS VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56219-2001
Mailing Address - Country:US
Mailing Address - Phone:612-499-0200
Mailing Address - Fax:
Practice Address - Street 1:1700 HIGHWAY 36 W
Practice Address - Street 2:SUITE 880
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-4034
Practice Address - Country:US
Practice Address - Phone:651-646-8046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR148513-2251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care