Provider Demographics
NPI:1063630051
Name:COMMUNICARE, INC
Entity Type:Organization
Organization Name:COMMUNICARE, INC
Other - Org Name:COMMUNICARE 8
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:WHITTEMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-888-1155
Mailing Address - Street 1:40 W FRANKLIN RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-2965
Mailing Address - Country:US
Mailing Address - Phone:208-888-1155
Mailing Address - Fax:208-888-1156
Practice Address - Street 1:1118 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:JEROME
Practice Address - State:ID
Practice Address - Zip Code:83338-1855
Practice Address - Country:US
Practice Address - Phone:208-888-1155
Practice Address - Fax:208-888-1156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID62320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities