Provider Demographics
NPI:1851834501
Name:CAPITAL CARE, INC
Entity Type:Organization
Organization Name:CAPITAL CARE, INC
Other - Org Name:CAPITAL CARE HOME CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:TIZIBONG
Authorized Official - Last Name:ATANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-787-0333
Mailing Address - Street 1:2401 BLUERIDGE AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4517
Mailing Address - Country:US
Mailing Address - Phone:202-787-0333
Mailing Address - Fax:
Practice Address - Street 1:6120 KANSAS AVE NW
Practice Address - Street 2:STE 201
Practice Address - City:WASHINGTON, DC
Practice Address - State:DC
Practice Address - Zip Code:20011
Practice Address - Country:US
Practice Address - Phone:202-787-0333
Practice Address - Fax:202-722-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC251E00000X, 251F00000X, 253Z00000X, 314000000X, 3140N1450X, 385H00000X
385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC087695759Medicaid