Provider Demographics
NPI: | 1457526956 |
---|---|
Name: | CAPITAL HEALTH SYSTEM |
Entity Type: | Organization |
Organization Name: | CAPITAL HEALTH SYSTEM |
Other - Org Name: | MERCER ADULT DAY CARE CENTER |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | NANCY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SCHLITTER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 609-394-4023 |
Mailing Address - Street 1: | 433 BELLEVUE AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | TRENTON |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 08618-4514 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 609-394-4387 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 433 BELLEVUE AVE |
Practice Address - Street 2: | |
Practice Address - City: | TRENTON |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08618-4514 |
Practice Address - Country: | US |
Practice Address - Phone: | 609-394-4387 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-04-25 |
Last Update Date: | 2008-04-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 311Z00000X | Nursing & Custodial Care Facilities | Custodial Care Facility |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NJ | 9087702 | Medicaid |