Provider Demographics
NPI:1083213789
Name:CAPITAL SK ENTERPRISES LLC
Entity Type:Organization
Organization Name:CAPITAL SK ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-597-6106
Mailing Address - Street 1:6183 LAUREL LN APT B
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-8135
Mailing Address - Country:US
Mailing Address - Phone:954-597-6106
Mailing Address - Fax:
Practice Address - Street 1:6183 LAUREL LN APT B
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-8135
Practice Address - Country:US
Practice Address - Phone:954-597-6106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERGENT CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health