Provider Demographics
NPI:1215367800
Name:CAPITOL CC, INC.
Entity Type:Organization
Organization Name:CAPITOL CC, INC.
Other - Org Name:CAPITOL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-467-6900
Mailing Address - Street 1:9015 MOUNTAIN RIDGE DR
Mailing Address - Street 2:STE 210
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-7370
Mailing Address - Country:US
Mailing Address - Phone:512-467-6900
Mailing Address - Fax:
Practice Address - Street 1:9015 MOUNTAIN RIDGE DR
Practice Address - Street 2:STE 210
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7370
Practice Address - Country:US
Practice Address - Phone:512-467-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health