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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