Provider Demographics
NPI:1881358091
Name:CAPITOL HEALTH CARE, LLC
Entity type:Organization
Organization Name:CAPITOL HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCC-SLP
Authorized Official - Prefix:
Authorized Official - First Name:KYOUNGHWA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:KWON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:105-054-5594
Mailing Address - Street 1:4115 SEARS HOUSE CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-5407
Mailing Address - Country:US
Mailing Address - Phone:410-505-4559
Mailing Address - Fax:
Practice Address - Street 1:4115 SEARS HOUSE CT
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-5407
Practice Address - Country:US
Practice Address - Phone:410-505-4559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty