Healthcare Provider Details

I. General information

NPI: 1932863578
Provider Name (Legal Business Name): CAPE SUPPORTIVE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2021
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

956 ASBURY AVE FL 2
OCEAN CITY NJ
08226-3536
US

IV. Provider business mailing address

956 ASBURY AVE FL 2
OCEAN CITY NJ
08226-3536
US

V. Phone/Fax

Practice location:
  • Phone: 609-318-4922
  • Fax:
Mailing address:
  • Phone: 609-318-4922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: HEATHER KOZUBA
Title or Position: OWNER
Credential: APN
Phone: 609-318-4922