Provider Demographics
NPI:1013147180
Name:HEALTHSTAFF SERVICES INC
Entity type:Organization
Organization Name:HEALTHSTAFF SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:GILGEOURS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-996-6226
Mailing Address - Street 1:PO BOX 152
Mailing Address - Street 2:
Mailing Address - City:LOVEJOY
Mailing Address - State:GA
Mailing Address - Zip Code:30250-0152
Mailing Address - Country:US
Mailing Address - Phone:770-996-6226
Mailing Address - Fax:770-996-6223
Practice Address - Street 1:144 ROY HUIE RD
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-1963
Practice Address - Country:US
Practice Address - Phone:770-996-6226
Practice Address - Fax:770-996-6223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031R0239251J00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA335088087AMedicaid