Provider Demographics
NPI:1518178672
Name:CAPITOL BUSINESS DEVELOPMENT INC.
Entity Type:Organization
Organization Name:CAPITOL BUSINESS DEVELOPMENT INC.
Other - Org Name:HEALTH CARE DUAL DIAGNOSIS PROGRAM II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-821-8023
Mailing Address - Street 1:5529 N CLEO AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-7713
Mailing Address - Country:US
Mailing Address - Phone:866-281-6882
Mailing Address - Fax:818-804-4047
Practice Address - Street 1:3131 UNION ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94608-4441
Practice Address - Country:US
Practice Address - Phone:866-281-6882
Practice Address - Fax:818-804-4047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder