Provider Demographics
NPI:1073237392
Name:NDI HEALTHCARE, LLC
Entity Type:Organization
Organization Name:NDI HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SABINA
Authorized Official - Middle Name:NGAH
Authorized Official - Last Name:NDI
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:978-930-9158
Mailing Address - Street 1:115 PEARL AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-4211
Mailing Address - Country:US
Mailing Address - Phone:978-930-9158
Mailing Address - Fax:
Practice Address - Street 1:115 PEARL AVE APT 1
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-4211
Practice Address - Country:US
Practice Address - Phone:978-930-9158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty