Provider Demographics
NPI:1043510977
Name:NIGHTINGALE RESOURCE CENTER, INC
Entity Type:Organization
Organization Name:NIGHTINGALE RESOURCE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:HYACINTH
Authorized Official - Middle Name:JENNIFER
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:910-488-4565
Mailing Address - Street 1:PO BOX 9376
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-9085
Mailing Address - Country:US
Mailing Address - Phone:910-488-4565
Mailing Address - Fax:910-488-4565
Practice Address - Street 1:320 LANCELOT CT
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NC
Practice Address - Zip Code:28356-8052
Practice Address - Country:US
Practice Address - Phone:910-488-4565
Practice Address - Fax:910-488-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRN 208291251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management