Healthcare Provider Details

I. General information

NPI: 1710464664
Provider Name (Legal Business Name): COMMCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 HWY 51
PONCHATOULA LA
70454-1560
US

IV. Provider business mailing address

950 W CAUSEWAY APPROACH
MANDEVILLE LA
70471-3082
US

V. Phone/Fax

Practice location:
  • Phone: 985-229-2112
  • Fax: 985-229-6992
Mailing address:
  • Phone: 504-324-8950
  • Fax: 985-624-3477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DAWN HARVEY PSARELLIS
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 504-324-8950