Provider Demographics
NPI:1740236157
Name:COMMUNITY ASSISTANCE COUNCIL INC
Entity Type:Organization
Organization Name:COMMUNITY ASSISTANCE COUNCIL INC
Other - Org Name:CONVENIENT HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BARON
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-813-1154
Mailing Address - Street 1:85 IH-10 NORTH
Mailing Address - Street 2:SUITE 215
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707
Mailing Address - Country:US
Mailing Address - Phone:409-813-1154
Mailing Address - Fax:409-813-1935
Practice Address - Street 1:85 IH-10 NORTH
Practice Address - Street 2:SUITE 215
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707
Practice Address - Country:US
Practice Address - Phone:409-813-1154
Practice Address - Fax:409-813-1935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008838251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
453198Medicare Oscar/Certification