Provider Demographics
NPI:1932863578
Name:CAPE SUPPORTIVE CARE
Entity Type:Organization
Organization Name:CAPE SUPPORTIVE CARE
Other - Org Name:CAPE SUPPORTIVE CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:KOZUBA
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:609-318-4922
Mailing Address - Street 1:956 ASBURY AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226-3536
Mailing Address - Country:US
Mailing Address - Phone:609-318-4922
Mailing Address - Fax:
Practice Address - Street 1:956 ASBURY AVE FL 2
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:NJ
Practice Address - Zip Code:08226-3536
Practice Address - Country:US
Practice Address - Phone:609-318-4922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No282N00000XHospitalsGeneral Acute Care HospitalGroup - Single Specialty