# COMMCARE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ponchatoula Community Care Center, Camelot Community Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710464664
- **Authorized official:** DAWN HARVEY PSARELLIS (CHIEF ADMINISTRATIVE OFFICER)
- **Authorized official phone:** (504) 324-8950

## Contact information

- **Practice address:** 1560 HWY 51, PONCHATOULA, LA 70454-1560
- **Practice address phone:** (985) 229-2112
- **Practice address fax:** (985) 229-6992
- **Mailing address:** 950 W CAUSEWAY APPROACH, MANDEVILLE, LA 70471-3082
- **Mailing address phone:** (504) 324-8950
- **Mailing address fax:** (985) 624-3477

## Taxonomy

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

## Other

- **Enumeration date:** 07/24/2018
- **Last updated:** 06/09/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1515027 | — | LA |