Provider Demographics
NPI:1568214443
Name:CAPITAL HOMECARE COOPERATIVE
Entity Type:Organization
Organization Name:CAPITAL HOMECARE COOPERATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:DISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-888-6175
Mailing Address - Street 1:PO BOX 6307
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98507-6307
Mailing Address - Country:US
Mailing Address - Phone:360-888-6175
Mailing Address - Fax:
Practice Address - Street 1:407 4TH AVE E STE 201
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1108
Practice Address - Country:US
Practice Address - Phone:360-888-6175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty