Provider Demographics
NPI:1841951951
Name:SIGNATURE STAFFING LLC
Entity type:Organization
Organization Name:SIGNATURE STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL VP
Authorized Official - Prefix:
Authorized Official - First Name:VONISHA
Authorized Official - Middle Name:LASHAWN
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:708-930-5031
Mailing Address - Street 1:4219 W 95TH ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-6510
Mailing Address - Country:US
Mailing Address - Phone:708-930-5031
Mailing Address - Fax:
Practice Address - Street 1:4219 W 95TH ST STE 1B
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-6510
Practice Address - Country:US
Practice Address - Phone:708-930-5031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care