Healthcare Provider Details

I. General information

NPI: 1639733827
Provider Name (Legal Business Name): CAPABLE HOME SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 S 7TH AVE
YUMA AZ
85364-5553
US

IV. Provider business mailing address

1625 S 7TH AVE
YUMA AZ
85364-5553
US

V. Phone/Fax

Practice location:
  • Phone: 716-308-2795
  • Fax:
Mailing address:
  • Phone: 716-308-2795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: DELISA S CLIFTON
Title or Position: CO-FOUNDER
Credential: PT,DPT,ECHM
Phone: 716-308-2795