Provider Demographics
NPI:1982004842
Name:NIGHTNGAIL ASSISTED LIVING
Entity Type:Organization
Organization Name:NIGHTNGAIL ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-974-1988
Mailing Address - Street 1:7621 PROSPECT AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4617
Mailing Address - Country:US
Mailing Address - Phone:505-797-0927
Mailing Address - Fax:505-797-0927
Practice Address - Street 1:7621 PROSPECT AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4617
Practice Address - Country:US
Practice Address - Phone:505-797-0927
Practice Address - Fax:505-797-0927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCU00010720310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility