MEDICARE: COMMUNITY EFFORTS LLC

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	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1811751241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY EFFORTS LLC

Provider Business Mailing Address
First Line	:	2370 QUINLAND LAKE RD STE 110
Second Line	:
City	:	COOKEVILLE
State	:	TN
Zip	:	38506-7518
Country	:	US
Telephone Number	:	931-337-5194
Fax Number	:

Provider Business Practice Location Address
First Line	:	2370 QUINLAND LAKE RD STE 110
Second Line	:
City	:	COOKEVILLE
State	:	TN
Zip	:	38506-7518
Country	:	US
Telephone Number	:	931-337-5194
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JAMES ELLOWAY BOURKE
Credential	:
Telephone Number	:	931-337-5194

Provider Enumeration Date	:	02/07/2024
Last Update Date	:	02/07/2024

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Directions to “COMMUNITY EFFORTS LLC ” Practice Location

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