Provider Demographics
NPI:1013414473
Name:NIGHTINGALE ORGANIZATION FOR BEHAVIORAL SERVICES LLC
Entity Type:Organization
Organization Name:NIGHTINGALE ORGANIZATION FOR BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:FELICE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:203-313-8305
Mailing Address - Street 1:19 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-2124
Mailing Address - Country:US
Mailing Address - Phone:203-313-8305
Mailing Address - Fax:
Practice Address - Street 1:19 SHADY LN
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-2124
Practice Address - Country:US
Practice Address - Phone:203-313-8305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty