MEDICARE: PERSONAL ELDER CARE 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	310400000X	Assisted Living Facility	AL10513	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285831214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSONAL ELDER CARE INC.

Provider Business Mailing Address
First Line	:	4533 BROOK DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-8206
Country	:	US
Telephone Number	:	561-684-4960
Fax Number	:	561-683-9696

Provider Business Practice Location Address
First Line	:	4533 BROOK DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-8206
Country	:	US
Telephone Number	:	561-684-4960
Fax Number	:	561-683-9696

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. NALINI GOMATTIE PHALGOO
Credential	:
Telephone Number	:	561-684-4960

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	08/22/2020

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