Provider Demographics
NPI:1407106123
Name:CSN CAP SERVICES
Entity Type:Organization
Organization Name:CSN CAP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:HARLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-915-1404
Mailing Address - Street 1:231 4TH ST
Mailing Address - Street 2:
Mailing Address - City:AYDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28513-7094
Mailing Address - Country:US
Mailing Address - Phone:919-915-1404
Mailing Address - Fax:252-746-2910
Practice Address - Street 1:231 4TH ST
Practice Address - Street 2:
Practice Address - City:AYDEN
Practice Address - State:NC
Practice Address - Zip Code:28513-7094
Practice Address - Country:US
Practice Address - Phone:919-915-1404
Practice Address - Fax:252-746-2910
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHOSEN ONES HOME HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3492251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418186Medicaid