Provider Demographics
NPI:1407135080
Name:NIGHTINGALE HOME HEALTH LLC
Entity Type:Organization
Organization Name:NIGHTINGALE HOME HEALTH LLC
Other - Org Name:RECOVERY HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NWABUEZE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:702-331-5922
Mailing Address - Street 1:1913 BROKEN LANCE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-5090
Mailing Address - Country:US
Mailing Address - Phone:702-331-5922
Mailing Address - Fax:702-685-8761
Practice Address - Street 1:1913 BROKEN LANCE AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-5090
Practice Address - Country:US
Practice Address - Phone:702-331-5922
Practice Address - Fax:702-685-8761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-12
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6363HHA-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health