Provider Demographics
NPI:1477664365
Name:NIGHTINGALE OF HOUSTON, INC
Entity Type:Organization
Organization Name:NIGHTINGALE OF HOUSTON, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DEV
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:317-334-7777
Mailing Address - Street 1:275 MEDICAL DRIVE
Mailing Address - Street 2:PO BOX 1710
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:866-334-7777
Mailing Address - Fax:866-878-0094
Practice Address - Street 1:7207 REGENCY SQUARE BLVD STE 270
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3188
Practice Address - Country:US
Practice Address - Phone:713-343-3555
Practice Address - Fax:866-878-0094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011693251E00000X
TX004371251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
678372Medicare PIN