Provider Demographics
NPI:1417462391
Name:COMMUNITY CARE
Entity Type:Organization
Organization Name:COMMUNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-656-1514
Mailing Address - Street 1:7220 N. LINDBERGH STE 310
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042
Mailing Address - Country:US
Mailing Address - Phone:314-656-1514
Mailing Address - Fax:314-656-1555
Practice Address - Street 1:7220 N. LINDBERGH STE 310
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042
Practice Address - Country:US
Practice Address - Phone:314-656-1514
Practice Address - Fax:314-656-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty