Provider Demographics
NPI:1881923936
Name:NIGHTINGALE HOME HEALTHCARE OF MASSACHUSETTS, INC.
Entity type:Organization
Organization Name:NIGHTINGALE HOME HEALTHCARE OF MASSACHUSETTS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEV
Authorized Official - Middle Name:ANUROOP
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-334-7777
Mailing Address - Street 1:1036 S RANGE LINE RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2544
Mailing Address - Country:US
Mailing Address - Phone:317-334-7777
Mailing Address - Fax:317-569-1403
Practice Address - Street 1:125 COUNTY ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3561
Practice Address - Country:US
Practice Address - Phone:866-334-7777
Practice Address - Fax:866-878-0094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0608084Medicaid
MA0608084Medicaid