Provider Demographics
NPI:1396896957
Name:COMCARE, INC.
Entity type:Organization
Organization Name:COMCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-638-3926
Mailing Address - Street 1:100 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-4624
Mailing Address - Country:US
Mailing Address - Phone:423-638-3926
Mailing Address - Fax:423-638-1105
Practice Address - Street 1:100 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-4624
Practice Address - Country:US
Practice Address - Phone:423-638-3926
Practice Address - Fax:423-638-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000015096251C00000X
TNL000000017028251C00000X
251C00000X, 253J00000X, 320900000X, 385HR2060X, 251J00000X
TNPSS00000000281251J00000X
TNL000000015095253J00000X, 320900000X, 385HR2060X
TNL000000017024253J00000X, 320900000X, 385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253J00000XAgenciesFoster Care Agency
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNL000000015095OtherCOMMUNITY BASED RESIDENTIAL TREATMENT, MENTAL RETARDATION