NPIMap

Organization Active NPI

Commcare Corporation

  • Skilled Nursing Facility
  • Lake Charles, LA
National Provider Identifier
1114102738
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COMMCARE CORPORATION
Practice address
4190 Gerstner Memorial Blvd
Lake Charles, LA 70607
Phone
(337) 240-9730
Fax
(337) 240-9731
NPI assigned
Jan 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dawn Harvey Psarellis
Title
Secretary
Phone
(504) 324-8950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4190 Gerstner Memorial Blvd
Lake Charles, LA 70607

Mailing address

4190 Gerstner Memorial Blvd
Lake Charles, LA 70607-3804
Phone (337) 439-5761

Other identifiers 1

IdentifierTypeStateIssuer
1512303MedicaidLA

Other names 1

  • Calcasieu Community Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221202001665 LA Part A Provider - Skilled Nursing Facility 3375437932 Practice locations: Lake Charles, LA

Skilled nursing facility certification: CCN 195644

Legal name
COMMCARE CORPORATION
Doing business as
CALCASIEU COMMUNITY CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 4, 2022
Last certification
Oct 9, 2024
Beds
120
Ownership / control type
Nonprofit Corporation
Multi-facility organization
CommCare Corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 12, 1984 in LA
Enrollment address
4190 Gerstner Memorial Blvd
Lake Charles, LA 70607
Nursing home name
CALCASIEU COMMUNITY CARE CENTER
Affiliated entity
COMMCARE CORPORATION

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

Care Compare: Nursing home

Medicare Care Compare
Listed as
Calcasieu Community Care CenterCCN 195644
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Nov 4, 2022
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120115.0 residents per day on average
Chain
Commcare Corporation14 facilities in the chain
Penalties (3 years)
1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
D Ville House19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

4190 Gerstner Memorial Blvd
Lake Charles, LA 70607
Phone (318) 281-6933

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
George E Gardner Individual Operational/Managerial ControlVP, Coo Sep 30, 2022 20%
James W Tucker Individual Operational/Managerial ControlPresident, Ceo Sep 30, 2022 20%
Alec Lundberg Individual Corporate OfficerCfo Sep 30, 2022 20%
W-2 Managing EmployeeVP, Cao Sep 30, 2022 20%
Operational/Managerial ControlVP, Cfo Sep 30, 2022 20%
Michael a Ford Individual Corporate DirectorDirector Sep 30, 2022 25%
Dawn R Harvey Psarellis Individual Corporate OfficerSecretary Sep 30, 2022
W-2 Managing EmployeeVP, Chief Administrative Sep 30, 2022 20%
Patricia M Prechter Individual Corporate OfficerPresident and Ceo Sep 30, 2022
Corporate DirectorPresident Sep 30, 2022 25%
W-2 Managing EmployeeCeo Sep 30, 2022
Commcare Corporation Organization, Mandeville, LA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 30, 2022 100%
Wayne R Plaisance Individual Corporate DirectorDirector Sep 30, 2020 25%
Mary C Hudson Individual W-2 Managing EmployeeController Sep 30, 2022
Operational/Managerial ControlController Sep 30, 2022
Garold a Mangun Individual Corporate OfficerChairman of the Board Sep 30, 2022
Corporate DirectorChairman of the Board Sep 30, 2022 25%
Commcare Management Corporation Organization, Mandeville, LA Corporation, Management services company, For-profit Operational/Managerial Control Sep 30, 2022 25%

Owners & managing parties with NPI records 14

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 14

All facility ownership & control disclosures 13

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Old Jefferson Community Care CenterBaton Rouge, LA, CCN 195571 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 1994
Natchitoches Community Care CenterNatchitoches, LA, CCN 195405 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 1994
Tioga Community Care CenterPineville, LA, CCN 195500 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 1994
Riviere de Soleil Community Care CenterMansura, LA, CCN 195489 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 1994
Ridgecrest Community Care CenterWest Monroe, LA, CCN 195528 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 1994
Greenbriar Community Care CenterSlidell, LA, CCN 195301 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 1994
Baton Rouge Healthcare CenterBaton Rouge, LA, CCN 195361 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 1994
Guest House of SlidellSlidell, LA, CCN 195302 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2008
Old Brownlee Community Care CenterBossier City, LA, CCN 195363 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 1994
Ponchatoula Community Care CenterPonchatoula, LA, CCN 195543 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2021
Chateau de Notre Dame Community Care CenterNew Orleans, LA, CCN 195589 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 14, 2023
Chateau de Notre Dame Community Care CenterNew Orleans, LA, CCN 195509 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 14, 2023
Wynhoven Community Care CenterMarrero, LA, CCN 195210 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 14, 2023

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

Facilities with the same owner 17

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 17

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1114102738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 GERSTNER MEMORIAL BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706073804",
            "telephone_number": "337-439-5761",
            "fax_number": "337-433-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 GERSTNER MEMORIAL BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70607",
            "telephone_number": "337-240-9730",
            "fax_number": "337-240-9731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "PSARELLIS",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "HARVEY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "504-324-8950"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1512303",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calcasieu Community Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Calcasieu Community Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.