Provider Demographics
NPI:1679559587
Name:NIGHTINGALE HEALTH CARE INC
Entity type:Organization
Organization Name:NIGHTINGALE HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NGOZI
Authorized Official - Middle Name:IFEYINWA
Authorized Official - Last Name:OKAGBUE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:617-323-1606
Mailing Address - Street 1:1759 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-1535
Mailing Address - Country:US
Mailing Address - Phone:617-323-1606
Mailing Address - Fax:617-327-8073
Practice Address - Street 1:1759 CENTRE ST
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-1535
Practice Address - Country:US
Practice Address - Phone:617-323-1606
Practice Address - Fax:617-327-8073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227481251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0605701Medicaid
MA227481Medicare ID - Type UnspecifiedPROVIDER NUMBER