Provider Demographics
NPI:1033599428
Name:NILE HEALTH LLC
Entity Type:Organization
Organization Name:NILE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:617-669-1789
Mailing Address - Street 1:15 MIDDLESEX RD
Mailing Address - Street 2:#2
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452-6171
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 MIDDLESEX RD
Practice Address - Street 2:#2
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02452-6171
Practice Address - Country:US
Practice Address - Phone:617-669-1789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2264775251E00000X
MA2270963251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care