Organization
PRO STAFF STAT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEISHA HOWARD (EXECUTIVE DIRECTOR)
(313) 977-6954
Entity
Organization
Contact information
Practice address
15200 E. JEFFERSON AVENUE, GROSSE POINTE PARK, MI 48230-1304
(313) 821-2257
Mailing address
15200 E JEFFERSON AVE, GROSSE POINTE PARK, MI 48230-1304
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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