Provider Demographics
NPI:1619467545
Name:CAPITAL TRANSITIONAL CENTER PA
Entity Type:Organization
Organization Name:CAPITAL TRANSITIONAL CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANESH
Authorized Official - Middle Name:
Authorized Official - Last Name:SADARANGANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-999-2328
Mailing Address - Street 1:2857 HANNON HILL DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-8985
Mailing Address - Country:US
Mailing Address - Phone:850-999-2328
Mailing Address - Fax:850-320-6114
Practice Address - Street 1:1845 JACLIF CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-999-2328
Practice Address - Fax:850-320-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty