Provider Demographics
NPI:1063389096
Name:NEAL, CASSANDRA L
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:L
Last Name:NEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 HARRISON ST STE 307
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-2971
Mailing Address - Country:US
Mailing Address - Phone:219-382-0100
Mailing Address - Fax:
Practice Address - Street 1:6111 HARRISON ST STE 307
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-2971
Practice Address - Country:US
Practice Address - Phone:219-382-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN25-0186331253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care