Healthcare Provider Details

I. General information

NPI: 1942147202
Provider Name (Legal Business Name): CAPRIA GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16617 ALDEN AVE
GAITHERSBURG MD
20877-1503
US

IV. Provider business mailing address

16617 ALDEN AVE
GAITHERSBURG MD
20877-1503
US

V. Phone/Fax

Practice location:
  • Phone: 301-204-7492
  • Fax: 301-204-7492
Mailing address:
  • Phone: 301-204-7492
  • Fax: 301-204-7492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ANDRIAN GOODUM
Title or Position: OWNER
Credential:
Phone: 301-204-7492