Provider Demographics
NPI:1578278453
Name:CAPITAL HEALTH ASSISTED LIVING PROGRAM
Entity Type:Organization
Organization Name:CAPITAL HEALTH ASSISTED LIVING PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF POPULATION OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DAFILOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-394-6000
Mailing Address - Street 1:601 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08629-1915
Mailing Address - Country:US
Mailing Address - Phone:609-394-6000
Mailing Address - Fax:609-394-6687
Practice Address - Street 1:601 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08629-1915
Practice Address - Country:US
Practice Address - Phone:609-394-6000
Practice Address - Fax:609-394-6687
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POPULATION HEALTH MANAGEMENT SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility