Provider Demographics
NPI:1205163185
Name:MISSION MEDSTAFF, LLC
Entity type:Organization
Organization Name:MISSION MEDSTAFF, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-532-3187
Mailing Address - Street 1:7300 STATE HIGHWAY 121 STE 250
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1991
Mailing Address - Country:US
Mailing Address - Phone:903-532-1400
Mailing Address - Fax:866-971-2126
Practice Address - Street 1:1233 W MOREHEAD ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208
Practice Address - Country:US
Practice Address - Phone:704-295-0822
Practice Address - Fax:866-971-2126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-12
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4096251E00000X, 251F00000X, 253Z00000X, 251J00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing CareGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7100649Medicaid
NC3 418800Medicaid
NCHC4096OtherDEPARTMENT OF HEALTH AND HUMAN SERVICES/DIVISION OF HEALTH SERVICE REGULATION
NC6602032Medicaid