Provider Demographics
NPI:1972942654
Name:COMMUNI-CARE, LLC
Entity Type:Organization
Organization Name:COMMUNI-CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JH
Authorized Official - Last Name:YAEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-545-1114
Mailing Address - Street 1:221 S UNION AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3490
Mailing Address - Country:US
Mailing Address - Phone:719-545-1114
Mailing Address - Fax:719-546-6154
Practice Address - Street 1:221 S UNION AVE # A
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3490
Practice Address - Country:US
Practice Address - Phone:719-545-1114
Practice Address - Fax:719-546-6154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COO4N228253Z00000X
385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO43554512Medicaid