Healthcare Provider Details

I. General information

NPI: 1316973696
Provider Name (Legal Business Name): NIGHTINGALE REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8103 DUNLAP ST
HOUSTON TX
77074-7828
US

IV. Provider business mailing address

5802 HOLLY ST
HOUSTON TX
77074-7838
US

V. Phone/Fax

Practice location:
  • Phone: 713-981-1571
  • Fax: 713-981-1571
Mailing address:
  • Phone: 713-981-1543
  • Fax: 713-995-6376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number114923
License Number StateTX

VIII. Authorized Official

Name: MR. PHILIP CHUNG
Title or Position: ONWER
Credential:
Phone: 713-981-1543