Healthcare Provider Details

I. General information

NPI: 1316905870
Provider Name (Legal Business Name): COMMCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 02/18/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 WELLERMAN RD
WEST MONROE LA
71291-7427
US

IV. Provider business mailing address

1616 WELLERMAN RD
WEST MONROE LA
71291-7427
US

V. Phone/Fax

Practice location:
  • Phone: 318-387-2577
  • Fax: 318-325-8662
Mailing address:
  • Phone: 318-387-2577
  • Fax: 318-325-8662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number156
License Number StateLA

VIII. Authorized Official

Name: DAWN HARVEY PSARELLIS
Title or Position: VICE PRESIDENT, CAO
Credential:
Phone: 504-324-8950