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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
915 10TH ST, DE WITT, IA 52742-1252
(563) 659-4100
(563) 659-1120
Mailing address
108 INDUSTRIAL ST, DE WITT, IA 52742-2063
(563) 659-4100
(563) 659-1120

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
230519
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0881995
IA
Enumeration date
12/15/2006
Last updated
08/22/2020
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