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NPI 1053433631

NPI 1053433631 : NIGHTINGALE NURSES HOME HEALTH AGENCY : DESOTO, TX

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General NPI Number Information
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    NPI Number           |    1053433631
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    Entity Type          |    Organization 
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    Legal Business Name  |    NIGHTINGALE NURSES HOME HEALTH AGENCY 
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Dates
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    Enumeration Date     |    04/04/2007
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    Last Update Date     |    01/14/2008
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Provider Practice Location Address
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    Address Line         |    1510 N HAMPTON RD SUITE 210
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    City                 |    DESOTO
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    State                |    TX
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    Zip                  |    75115-8300
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    Country              |    US
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    Telephone            |    972-228-8283
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    Fax                  |    972-228-8286
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Provider Business Mailing Address
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    Address Line         |    1510 N HAMPTON RD SUITE 210
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    City                 |    DESOTO
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    State                |    TX
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    Zip                  |    75115-8300
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    Country              |    US
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    Telephone            |    972-228-8283
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    Fax                  |    972-228-8286
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Authorized Official
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    Title or Position    |    ADMINISTRATOR
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    Name                 |    MRS. FRESHELLE DENISE WINN 
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    Credential           |    
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    Telephone            |    972-228-8283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    002007
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    License Number State |    TX
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