Healthcare Provider Details

I. General information

NPI: 1154635910
Provider Name (Legal Business Name): CAPITAL PROFESSIONAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2010
Last Update Date: 08/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 FRANKLIN AVE STE. 108-101
KENT OH
44240-4383
US

IV. Provider business mailing address

1640 FRANKLIN AVE STE. 108-101
KENT OH
44240-4383
US

V. Phone/Fax

Practice location:
  • Phone: 330-673-7500
  • Fax: 330-673-1537
Mailing address:
  • Phone: 330-673-7500
  • Fax: 330-673-1537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ERIC GERARD FRENCH
Title or Position: CHIEF EXECUTIVE OFFICE
Credential:
Phone: 330-673-7500