Provider Demographics
NPI:1538589718
Name:STAFFING VILLAGE INC.
Entity type:Organization
Organization Name:STAFFING VILLAGE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRINIDA
Authorized Official - Middle Name:LOVE
Authorized Official - Last Name:KOLLIE-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:484-888-1622
Mailing Address - Street 1:1130 GLEN AVON RD
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-1414
Mailing Address - Country:US
Mailing Address - Phone:484-889-9792
Mailing Address - Fax:484-494-7385
Practice Address - Street 1:1130 GLEN AVON RD
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1414
Practice Address - Country:US
Practice Address - Phone:484-540-7697
Practice Address - Fax:484-494-7385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-26
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05300501253Z00000X, 251S00000X, 252Y00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency