MEDICARE: COMMCARE CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	849	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	31097	OTHER	LA	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639136989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMCARE CORPORATION

Provider Business Mailing Address
First Line	:	5550 THOMAS RD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70811-7354
Country	:	US
Telephone Number	:	225-774-2141
Fax Number	:	225-774-2143

Provider Business Practice Location Address
First Line	:	5550 THOMAS RD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70811-7354
Country	:	US
Telephone Number	:	225-774-2141
Fax Number	:	225-774-2143

Authorized Official
Title or Position	:	AUTHORIZED REPRESENTATIVE
Name	:	MS. DAWN H PSARELLIS
Credential	:
Telephone Number	:	504-324-8950

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	02/18/2021

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Directions to “COMMCARE CORPORATION ” Practice Location

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