Healthcare Provider Details
I. General information
NPI: 1245231992
Provider Name (Legal Business Name): COMMCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/03/2005
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1050 MEDICAL CENTER BLVD
MARRERO LA
70072-3144
US
IV. Provider business mailing address
950 W CAUSEWAY APPROACH
MANDEVILLE LA
70471-3082
US
V. Phone/Fax
- Phone: 504-347-0777
- Fax: 504-341-7240
- Phone: 504-324-8950
- Fax: 985-624-3477
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAWN
HARVEY
PSARELLIS
Title or Position: VP, CAO
Credential:
Phone: 504-324-8950