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General NPI Number Information
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NPI Number | 1316027998
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Entity Type | Organization
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Legal Business Name | NHI HOME BASE SERVICE CORP.
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 4795 BROADWAY
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City | GARY
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State | IN
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Zip | 46409
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Country | US
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Telephone | 219-887-3688
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Fax | 219-887-2666
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Provider Business Mailing Address
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Address Line | 4795 BROADWAY
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City | GARY
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State | IN
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Zip | 46409-2403
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Country | US
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Telephone | 219-887-3688
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Fax | 219-887-2666
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Authorized Official
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Title or Position | CHIEF OF OPERATIONS
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Name | MS. PAULA L. NALLS IX
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Credential |
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Telephone | 219-887-3688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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