# COMMCARE CORPORATION

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

## Provider details

- **NPI number:** 1619935905
- **Authorized official:** MS. DAWN H PSARELLIS (AUTHORIZED REPRESENTATIVE)
- **Authorized official phone:** (504) 324-8950

## Contact information

- **Practice address:** 5201 SHREVEPORT HWY, PINEVILLE, LA 71360-3527
- **Practice address phone:** (318) 640-3014
- **Practice address fax:** (318) 640-4927
- **Mailing address:** 5201 SHREVEPORT HWY, PINEVILLE, LA 71360-3527
- **Mailing address phone:** (318) 640-3014
- **Mailing address fax:** (318) 640-4927

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 332 | LA | Yes |

## Other

- **Enumeration date:** 05/03/2006
- **Last updated:** 02/18/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1520225 | — | LA |
| 01 | — | 30856 | BLUE CROSS BLUE SHIELD | LA |