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Contact Information

MISSISSIPPI COMMCARE CORPORATION A NON PROFIT CORPORATION
4036 HIGHWAY 8 EAST
CLEVELAND, MS38732
 Phone: 662-843-4014
 Fax: 662-843-5401
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for MISSISSIPPI COMMCARE CORPORATION A NON PROFIT CORPORATION

NPI Number 1891860656
LBN Legal business name MISSISSIPPI COMMCARE CORPORATION A NON PROFIT CORPORATION
Authorized official DAWN PSARELLIS - (VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/21/2006
Last updated 05/15/2026 - About 3 weeks ago
Identifiers
MS License # 380
MS Medicaid 005621394
MS Medicaid 05621394
MS Other 000080386 BC BS OF MISSISSIPPI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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