Provider Demographics
NPI:1528397015
Name:NEALEN PERSONAL CARE, INC.
Entity Type:Organization
Organization Name:NEALEN PERSONAL CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GROVE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:814-322-3401
Mailing Address - Street 1:1944 WILLIAM PENN AVE.
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15909-1637
Mailing Address - Country:US
Mailing Address - Phone:814-322-3401
Mailing Address - Fax:814-322-3911
Practice Address - Street 1:1944 WILLIAM PENN AVE.
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15909-1637
Practice Address - Country:US
Practice Address - Phone:814-322-3401
Practice Address - Fax:814-322-3911
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEALEN PERSONAL CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-14
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 253Z00000X
PA101799340251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101799340Medicaid
PA101799340 0003OtherDPW/ MA NUMBER
PA101799340 0006OtherDPW/MA NUMBER
PA101799340 0001OtherDPW/ MA NUMBER