Community Personal Care Service LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

PCA 8677 Issued in LA

Legal business name

COMMUNITY PERSONAL CARE SERVICE LLC

Practice address

123 Westmark Blvd
Lafayette, LA 70506-7345

Phone

(337) 806-9190

Fax

(337) 806-9185

NPI assigned

Jun 23, 2015

Organization subpart

No

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

Authorized official

Name

Dawn L Dugas

Title

Administrator

Phone

(337) 806-9190

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Community Personal Care Service Doing business as

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1962884221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 WESTMARK BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705067345",
            "telephone_number": "337-806-9190",
            "fax_number": "337-806-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 WESTMARK BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705067345",
            "telephone_number": "337-806-9190",
            "fax_number": "337-806-9185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PERSONAL CARE SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "DUGAS",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "337-806-9190"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "LA",
            "license": "PCA 8677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1460516",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1166065",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507091",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1432032",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Personal Care Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.