Provider Demographics
NPI:1407813652
Name:COMMCARE CORPORATION
Entity Type:Organization
Organization Name:COMMCARE CORPORATION
Other - Org Name:COMMUNITY CARE CENTER OF BAKER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, CAO
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:H
Authorized Official - Last Name:PSARELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-324-8950
Mailing Address - Street 1:8340 BARINGER FOREMAN RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-6252
Mailing Address - Country:US
Mailing Address - Phone:225-275-3203
Mailing Address - Fax:225-753-3721
Practice Address - Street 1:8340 BARINGER FOREMAN RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-6252
Practice Address - Country:US
Practice Address - Phone:225-275-3203
Practice Address - Fax:225-753-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA310314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1520144Medicaid
LA34466OtherBC/BS
LA34466OtherBC/BS