Provider Demographics
NPI:1093974313
Name:CAPITAL EMPOWERMENT CENTER
Entity Type:Organization
Organization Name:CAPITAL EMPOWERMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:M
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-598-2565
Mailing Address - Street 1:PO BOX 47074
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-7074
Mailing Address - Country:US
Mailing Address - Phone:410-598-2565
Mailing Address - Fax:
Practice Address - Street 1:2513 N ROLLING RD
Practice Address - Street 2:MAIL STOP 47074
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-1919
Practice Address - Country:US
Practice Address - Phone:410-598-2565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities