Provider Demographics
NPI:1700412962
Name:CAPITAL DISTRICT CARE GROUP LLC
Entity Type:Organization
Organization Name:CAPITAL DISTRICT CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NARELY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAPATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-407-3380
Mailing Address - Street 1:350 NORTHERN BLVD STE 324-1095
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12204-1000
Mailing Address - Country:US
Mailing Address - Phone:518-764-1564
Mailing Address - Fax:518-650-7491
Practice Address - Street 1:350 NORTHERN BLVD STE 324-1095
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12204-1000
Practice Address - Country:US
Practice Address - Phone:518-764-1564
Practice Address - Fax:518-650-7491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-19
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management