Healthcare Provider Details

I. General information

NPI: 1184442170
Provider Name (Legal Business Name): CAPITAL COMPASSION CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10151 CROYDON WAY STE 3
SACRAMENTO CA
95827-2106
US

IV. Provider business mailing address

PO BOX 276267
SACRAMENTO CA
95827-6267
US

V. Phone/Fax

Practice location:
  • Phone: 916-856-5683
  • Fax:
Mailing address:
  • Phone: 916-856-5683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: RICK J COLE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 916-856-5683