Provider Demographics
NPI:1972004083
Name:NIGHTINGALE HOME CARE, LLC
Entity Type:Organization
Organization Name:NIGHTINGALE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-749-0054
Mailing Address - Street 1:645 SADDLE DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-3816
Mailing Address - Country:US
Mailing Address - Phone:314-656-6156
Mailing Address - Fax:
Practice Address - Street 1:645 SADDLE DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-3816
Practice Address - Country:US
Practice Address - Phone:314-749-0054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-23
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health