Provider Demographics
NPI:1215751201
Name:VERSA FORCE LLC
Entity type:Organization
Organization Name:VERSA FORCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:NKUBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-381-7606
Mailing Address - Street 1:19100 61ST AVE NE APT C
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-3263
Mailing Address - Country:US
Mailing Address - Phone:971-381-7606
Mailing Address - Fax:
Practice Address - Street 1:10637 NE COXLEY DR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6119
Practice Address - Country:US
Practice Address - Phone:971-381-7606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)