Provider Demographics
NPI:1447967518
Name:COMMUNITY CARES OPTIONS
Entity type:Organization
Organization Name:COMMUNITY CARES OPTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:MASSA
Authorized Official - Middle Name:TORMAI
Authorized Official - Last Name:PASSAWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-320-9519
Mailing Address - Street 1:15 21ST ST S STE 102
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-1435
Mailing Address - Country:US
Mailing Address - Phone:270-320-9519
Mailing Address - Fax:
Practice Address - Street 1:15 21ST ST S STE 102
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-1435
Practice Address - Country:US
Practice Address - Phone:270-320-9519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1486341Medicaid