Provider Demographics
NPI:1659918381
Name:CAPITAL CARING ADVANCED ILLNESS SERVICES, INC
Entity Type:Organization
Organization Name:CAPITAL CARING ADVANCED ILLNESS SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:KESTENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-957-1888
Mailing Address - Street 1:3180 FAIRVIEW PARK DRIVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042
Mailing Address - Country:US
Mailing Address - Phone:703-712-4874
Mailing Address - Fax:
Practice Address - Street 1:3180 FAIRVIEW PARK DRIVE
Practice Address - Street 2:SUITE 600
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042
Practice Address - Country:US
Practice Address - Phone:703-712-4874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPITAL HOSPICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-02
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty