Provider Demographics
NPI:1427597327
Name:NTINGALE IN-HOUSE SKILLED NURSE. LLC
Entity Type:Organization
Organization Name:NTINGALE IN-HOUSE SKILLED NURSE. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTARATOR
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:ELMI
Authorized Official - Last Name:SULTHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-734-8905
Mailing Address - Street 1:416 31ST AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-1528
Mailing Address - Country:US
Mailing Address - Phone:651-734-8905
Mailing Address - Fax:763-333-1577
Practice Address - Street 1:416 31ST AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-1528
Practice Address - Country:US
Practice Address - Phone:651-734-8905
Practice Address - Fax:763-333-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN380571251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health