Provider Demographics
NPI:1063230183
Name:PREMIER STAFFING GROUP AGENCY L.L.C
Entity type:Organization
Organization Name:PREMIER STAFFING GROUP AGENCY L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:CHINWE
Authorized Official - Middle Name:P
Authorized Official - Last Name:OHAKA
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:248-787-1773
Mailing Address - Street 1:17700 NORTHLAND PARK CT STE 6
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4302
Mailing Address - Country:US
Mailing Address - Phone:248-787-1773
Mailing Address - Fax:216-208-1472
Practice Address - Street 1:17700 NORTHLAND PARK CT STE 6
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4302
Practice Address - Country:US
Practice Address - Phone:248-787-1773
Practice Address - Fax:216-208-1472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health