Provider Demographics
NPI:1982323499
Name:ENTECH MEDICAL STAFFING
Entity Type:Organization
Organization Name:ENTECH MEDICAL STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-743-1440
Mailing Address - Street 1:1800 CROOKS ROAD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-5446
Mailing Address - Country:US
Mailing Address - Phone:248-528-8090
Mailing Address - Fax:248-528-6983
Practice Address - Street 1:1800 CROOKS ROAD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-5446
Practice Address - Country:US
Practice Address - Phone:248-528-8090
Practice Address - Fax:248-528-6983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty