Provider Demographics
NPI:1730703570
Name:CROYLE-NIELSEN SUPPORT SERVICES, LLC
Entity type:Organization
Organization Name:CROYLE-NIELSEN SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NIELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-244-2390
Mailing Address - Street 1:336 BLOOMFIELD STREET
Mailing Address - Street 2:SUITE 203
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3271
Mailing Address - Country:US
Mailing Address - Phone:814-266-2244
Mailing Address - Fax:814-266-6296
Practice Address - Street 1:336 BLOOMFIELD STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3271
Practice Address - Country:US
Practice Address - Phone:814-266-2244
Practice Address - Fax:814-266-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-06
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management