Provider Demographics
NPI:1386771095
Name:MSB PERSONAL ASSISTANT SERVICES, LLC
Entity type:Organization
Organization Name:MSB PERSONAL ASSISTANT SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:MARSENE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BOLDT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-335-4882
Mailing Address - Street 1:16868 ROYAL CREST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2529
Mailing Address - Country:US
Mailing Address - Phone:281-335-4882
Mailing Address - Fax:281-984-7471
Practice Address - Street 1:1120 NASA PKWY STE 420
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3363
Practice Address - Country:US
Practice Address - Phone:281-335-4882
Practice Address - Fax:281-335-5514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008967251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health