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General NPI Number Information
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NPI Number | 1891638466
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE LIVING, LLC
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Dates
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Enumeration Date | 04/09/2026
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Last Update Date | 04/09/2026
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Provider Practice Location Address
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Address Line | 11746 S HARRELLS FERRY RD STE D
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City | BATON ROUGE
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State | LA
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Zip | 70816-2375
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Country | US
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Telephone | 225-256-0412
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Fax | 225-256-0908
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Provider Business Mailing Address
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Address Line | 11746 S HARRELLS FERRY RD STE D
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City | BATON ROUGE
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State | LA
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Zip | 70816-2375
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Country | US
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Telephone | 225-256-0412
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Fax | 225-256-0908
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. CHARLOTTA LORETTA MOORE
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Credential | RN
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Telephone | 225-256-0412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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