Provider Demographics
NPI:1083367262
Name:COMMUNITY CARES OPTIONS
Entity Type:Organization
Organization Name:COMMUNITY CARES OPTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MASSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PASSAWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-320-9519
Mailing Address - Street 1:3700 42ND ST S APT 107
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-6978
Mailing Address - Country:US
Mailing Address - Phone:270-320-9519
Mailing Address - Fax:
Practice Address - Street 1:15 21ST ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-1435
Practice Address - Country:US
Practice Address - Phone:610-510-5666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care