NPIMap

Organization Active NPI

Community Care, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Charlotte, IA
National Provider Identifier
1386771939
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
230904 Issued in IA
Legal business name
COMMUNITY CARE, INC
Practice address
1611 330TH Ave
Charlotte, IA 52731-9682
Phone
(563) 659-4100
Fax
(563) 677-2312
NPI assigned
Feb 28, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 230904 IA Primary

Addresses

Primary practice location

1611 330TH Ave
Charlotte, IA 52731-9682

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
02-43329MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Community Care Inc19 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

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386771939",
    "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": "1611 330TH AVE",
            "city": "CHARLOTTE",
            "state": "IA",
            "postal_code": "527319682",
            "telephone_number": "563-659-4100",
            "fax_number": "563-677-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "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": "230904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02-43329",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, 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.