Provider Demographics
NPI:1427203710
Name:CAPITAL BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:CAPITAL BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-955-3990
Mailing Address - Street 1:3215 CATHEDRAL AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-3410
Mailing Address - Country:US
Mailing Address - Phone:202-955-3990
Mailing Address - Fax:202-955-3996
Practice Address - Street 1:1310 SOUTHERN AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4623
Practice Address - Country:US
Practice Address - Phone:202-574-6504
Practice Address - Fax:202-373-5982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
153833OtherMEDICARE PART B PTAN