Provider Demographics
NPI:1760015440
Name:CAPITAL CARING STAY AT HOME SERVICE, INC
Entity Type:Organization
Organization Name:CAPITAL CARING STAY AT HOME SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PERFORMANCE & COMPLIANCE OFFI
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:EVERETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-712-4874
Mailing Address - Street 1:3180 FAIRVIEW PARK DRIVE
Mailing Address - Street 2:STE 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:STE 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 CARING HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty