Provider Demographics
NPI:1659436046
Name:NIGHTINGALE HOME HEALTHCARE OF NEVADA, INC
Entity Type:Organization
Organization Name:NIGHTINGALE HOME HEALTHCARE OF NEVADA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEV
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-334-7777
Mailing Address - Street 1:PO BOX 1710
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46082-1710
Mailing Address - Country:US
Mailing Address - Phone:866-334-7777
Mailing Address - Fax:317-569-1403
Practice Address - Street 1:6236 W DESERT INN RD STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6612
Practice Address - Country:US
Practice Address - Phone:702-240-9002
Practice Address - Fax:702-240-9008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3890HHA5251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV297109Medicare Oscar/Certification