Provider Demographics
NPI:1487743225
Name:STAFF ASSISTANCE, INC.
Entity type:Organization
Organization Name:STAFF ASSISTANCE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GERD
Authorized Official - Middle Name:F
Authorized Official - Last Name:KERSWILL
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:805-371-9988
Mailing Address - Street 1:468 PENNSFIELD PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5570
Mailing Address - Country:US
Mailing Address - Phone:805-371-9988
Mailing Address - Fax:805-371-9987
Practice Address - Street 1:17100 N 67TH AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3657
Practice Address - Country:US
Practice Address - Phone:623-486-2828
Practice Address - Fax:623-486-3116
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STAFF ASSISTANCE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-12
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA3136251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ037220Medicare Oscar/Certification