Provider Demographics
NPI:1467210864
Name:THE KAPTAIN CARE CORPORATION
Entity Type:Organization
Organization Name:THE KAPTAIN CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-336-0650
Mailing Address - Street 1:8520 ALLISON POINTE BLVD
Mailing Address - Street 2:STE 223 #52506
Mailing Address - City:INDIANPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250
Mailing Address - Country:US
Mailing Address - Phone:650-336-0650
Mailing Address - Fax:
Practice Address - Street 1:8520 ALLISON POINTE BLVD
Practice Address - Street 2:STE 223 #52506
Practice Address - City:INDIANPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250
Practice Address - Country:US
Practice Address - Phone:650-336-0650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center