Provider Demographics
NPI:1508083114
Name:COMM CARE CORP DBA
Entity Type:Organization
Organization Name:COMM CARE CORP DBA
Other - Org Name:DBA CMHC OF ALEXANDRIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-442-3163
Mailing Address - Street 1:140 FLAGON LOOP
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-3761
Mailing Address - Country:US
Mailing Address - Phone:318-442-3163
Mailing Address - Fax:318-442-4779
Practice Address - Street 1:4606 LEE STREET
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71360
Practice Address - Country:US
Practice Address - Phone:318-442-6163
Practice Address - Fax:318-442-4779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN080924261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health