Provider Demographics
NPI:1508249996
Name:CARECOMMUNITY INC.
Entity Type:Organization
Organization Name:CARECOMMUNITY INC.
Other - Org Name:CARECOMMUNITY HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMEON
Authorized Official - Middle Name:N
Authorized Official - Last Name:BONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-989-7474
Mailing Address - Street 1:4066 EVANS AVE
Mailing Address - Street 2:STE #4
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9384
Mailing Address - Country:US
Mailing Address - Phone:239-989-7474
Mailing Address - Fax:
Practice Address - Street 1:4066 EVANS AVE
Practice Address - Street 2:SUITE 18
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9384
Practice Address - Country:US
Practice Address - Phone:239-989-7474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X, 320900000X, 385H00000X
FL233813253Z00000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care