Provider Demographics
NPI:1174155758
Name:CAREGIVER STAFFING SOLUTIONS LLC
Entity type:Organization
Organization Name:CAREGIVER STAFFING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EBOU
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFUNEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-447-9465
Mailing Address - Street 1:6731 MARLOWE AVE NE
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330-7450
Mailing Address - Country:US
Mailing Address - Phone:763-447-9465
Mailing Address - Fax:
Practice Address - Street 1:3300 COUNTY ROAD 10 STE 120G
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-3064
Practice Address - Country:US
Practice Address - Phone:763-447-9465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care