Provider Demographics
NPI:1831566603
Name:COMMUNITY HOME CARE, LLC
Entity type:Organization
Organization Name:COMMUNITY HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BATTEAST
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:662-616-8660
Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-0597
Mailing Address - Country:US
Mailing Address - Phone:662-616-8660
Mailing Address - Fax:
Practice Address - Street 1:201 HIGHWAY 82 W
Practice Address - Street 2:SUITE E.
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-2141
Practice Address - Country:US
Practice Address - Phone:662-616-8660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care