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Organization
COMMCARE CORPORATION
Active
Organization
COMMCARE CORPORATION
Active
Other names
Ponchatoula Community Care Center, Camelot Community Care
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN HARVEY PSARELLIS (CHIEF ADMINISTRATIVE OFFICER)
(504) 324-8950
Entity
Organization
Contact information
Practice address
1560 HWY 51, PONCHATOULA, LA 70454-1560
(985) 229-2112
(985) 229-6992
Mailing address
950 W CAUSEWAY APPROACH, MANDEVILLE, LA 70471-3082
(504) 324-8950
(985) 624-3477
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1515027
—
LA
Enumeration date
07/24/2018
Last updated
06/09/2021
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