Provider Demographics
NPI:1003958687
Name:NIGHTINGALE HOSPICE CAE OF MINNESOTA INC
Entity Type:Organization
Organization Name:NIGHTINGALE HOSPICE CAE OF MINNESOTA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEV
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-334-7776
Mailing Address - Street 1:8085 WAYZATA BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1456
Mailing Address - Country:US
Mailing Address - Phone:866-334-7774
Mailing Address - Fax:763-546-1191
Practice Address - Street 1:8085 WAYZATA BLVD STE 105
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1456
Practice Address - Country:US
Practice Address - Phone:866-334-7774
Practice Address - Fax:763-546-1191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based