Organization
COMMUNITY CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN WRIGHT (EXECUTIVE DIRECTOR)
(563) 659-4100
Entity
Organization
Contact information
Practice address
13241 COUNTY HOME ROAD, E23, SCOTCH GROVE, IA 52310
(319) 462-3875
(563) 487-3623
Mailing address
108 INDUSTRIAL ST, DE WITT, IA 52742-2063
(563) 659-4100
(563) 659-1120
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
530041
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12-45142
—
IA
Enumeration date
03/09/2007
Last updated
08/22/2020
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