Provider Demographics
NPI:1770565822
Name:COMMUNITY CARE INC
Entity type:Organization
Organization Name:COMMUNITY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:RICKETSON
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:512-355-3184
Mailing Address - Street 1:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:BERTRAM
Mailing Address - State:TX
Mailing Address - Zip Code:78605-0193
Mailing Address - Country:US
Mailing Address - Phone:512-355-3184
Mailing Address - Fax:
Practice Address - Street 1:246 E HWY 29
Practice Address - Street 2:
Practice Address - City:BERTRAM
Practice Address - State:TX
Practice Address - Zip Code:78605
Practice Address - Country:US
Practice Address - Phone:512-355-3184
Practice Address - Fax:512-355-3186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities