MEDICARE: NIGHTINGALE OF HOUSTON, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	004371	TX
2	251E00000X	Home Health Agency	011693	TX

General Provider Information

NPI Number	:	1477664365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NIGHTINGALE OF HOUSTON, INC

Provider Business Mailing Address
First Line	:	275 MEDICAL DRIVE
Second Line	:	PO BOX 1710
City	:	CARMEL
State	:	IN
Zip	:	46032
Country	:	US
Telephone Number	:	866-334-7777
Fax Number	:	866-878-0094

Provider Business Practice Location Address
First Line	:	7207 REGENCY SQUARE BLVD STE 270
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-3188
Country	:	US
Telephone Number	:	713-343-3555
Fax Number	:	866-878-0094

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. DEV A BRAR
Credential	:	ADMINISTRATOR
Telephone Number	:	317-334-7777

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	03/17/2018

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