Provider Demographics
NPI:1528680816
Name:ADVANCED PRACTICE INTEGRATED HEALTH STAFFING, INC
Entity type:Organization
Organization Name:ADVANCED PRACTICE INTEGRATED HEALTH STAFFING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:JANELLE
Authorized Official - Last Name:WOLSKE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:269-462-9587
Mailing Address - Street 1:5616 COLOMA RD
Mailing Address - Street 2:
Mailing Address - City:COLOMA
Mailing Address - State:MI
Mailing Address - Zip Code:49038-9752
Mailing Address - Country:US
Mailing Address - Phone:269-252-1394
Mailing Address - Fax:
Practice Address - Street 1:756 PIPESTONE ST STE 3
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-4845
Practice Address - Country:US
Practice Address - Phone:269-252-1394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-11
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1134897812Medicaid
MI1528680816Medicaid