Provider Demographics
NPI:1790706935
Name:CAPITAL HOSPICE
Entity Type:Organization
Organization Name:CAPITAL HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:KESTENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-957-1888
Mailing Address - Street 1:3180 FAIRVIEW PARK DR STE 500
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-4583
Mailing Address - Country:US
Mailing Address - Phone:703-538-2066
Mailing Address - Fax:703-532-1054
Practice Address - Street 1:5225 WISCONSIN AVE NW STE 503
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2034
Practice Address - Country:US
Practice Address - Phone:202-244-8300
Practice Address - Fax:202-244-1413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC54192XXXX-65000704251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC022013500Medicaid
DC117743OtherKAISER PERMANENTE
DC117743OtherKAISER PERMANENTE