NPIMap

Organization Active NPI

Community Care, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Scotch Grove, IA
National Provider Identifier
1083746978
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
530041 Issued in IA
Legal business name
COMMUNITY CARE, INC
Practice address
13241 County Home Road
E23
Scotch Grove, IA 52310
Phone
(319) 462-3875
Fax
(563) 487-3623
NPI assigned
Mar 9, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Benjamin Wright
Title
Executive Director
Phone
(563) 659-4100

Corporate family (same tax ID) 18

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

National Provider Directory
Tax ID family
Community Care Inc (19 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 530041 IA Primary

Addresses

NPPES NPI Registry

Primary practice location

13241 County Home Road
E23
Scotch Grove, IA 52310

Mailing address

108 Industrial St
De Witt, IA 52742-2063
Phone (563) 659-4100

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
12-45142MedicaidIA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083746978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 INDUSTRIAL ST",
            "city": "DE WITT",
            "state": "IA",
            "postal_code": "527422063",
            "telephone_number": "563-659-4100",
            "fax_number": "563-659-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13241 COUNTY HOME ROAD",
            "address_2": "E23",
            "city": "SCOTCH GROVE",
            "state": "IA",
            "postal_code": "52310",
            "telephone_number": "319-462-3875",
            "fax_number": "563-487-3623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "563-659-4100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "IA",
            "license": "530041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12-45142",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scotch Grove, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.