Provider Demographics
NPI:1871897132
Name:PINES HEALTH CARE STAFFING SERVICE
Entity type:Organization
Organization Name:PINES HEALTH CARE STAFFING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GENUS
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:954-367-6733
Mailing Address - Street 1:6067 HOLLYWOOD BLVD
Mailing Address - Street 2:SUITE # 300
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-7947
Mailing Address - Country:US
Mailing Address - Phone:954-367-6733
Mailing Address - Fax:
Practice Address - Street 1:6067 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE # 300
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-7947
Practice Address - Country:US
Practice Address - Phone:954-367-6733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1327251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health