Provider Demographics
NPI:1063839785
Name:GENERATIONS PERSONAL CARE, INC
Entity Type:Organization
Organization Name:GENERATIONS PERSONAL CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDENFELSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-327-1199
Mailing Address - Street 1:942 SCHOFIELD LN
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-7431
Mailing Address - Country:US
Mailing Address - Phone:505-327-1199
Mailing Address - Fax:505-327-1197
Practice Address - Street 1:942 SCHOFIELD LN
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-7431
Practice Address - Country:US
Practice Address - Phone:505-327-1199
Practice Address - Fax:505-327-1197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM289257343747A0650X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM28925734Medicaid
NMF1576Medicaid