Provider Demographics
NPI:1285329417
Name:CIS STAFFING III LLC
Entity type:Organization
Organization Name:CIS STAFFING III LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAVELY
Authorized Official - Middle Name:
Authorized Official - Last Name:POLANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-870-2739
Mailing Address - Street 1:15 N 6TH ST # 304
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3505
Mailing Address - Country:US
Mailing Address - Phone:973-870-2739
Mailing Address - Fax:484-709-8193
Practice Address - Street 1:15 N 6TH ST # 304
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3505
Practice Address - Country:US
Practice Address - Phone:973-870-2739
Practice Address - Fax:484-709-8193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-05
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty