# COMMCARE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Calcasieu Community Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114102738
- **Authorized official:** DAWN HARVEY PSARELLIS (SECRETARY)
- **Authorized official phone:** (504) 324-8950

## Contact information

- **Practice address:** 4190 GERSTNER MEMORIAL BLVD, LAKE CHARLES, LA 70607
- **Practice address phone:** (337) 240-9730
- **Practice address fax:** (337) 240-9731
- **Mailing address:** 4190 GERSTNER MEMORIAL BLVD, LAKE CHARLES, LA 70607-3804
- **Mailing address phone:** (337) 439-5761
- **Mailing address fax:** (337) 433-4778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 01/02/2008
- **Last updated:** 04/12/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1512303 | — | LA |