Organization
CAPITOL DIVERSIFIED SERVICES, LLC
Active
Other names
Living At Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD D BENNETT (CHIEF EXECUTIVE MEMBER)
(512) 767-0055
Entity
Organization
Contact information
Practice address
7724 EL DORADO DR, AUSTIN, TX 78737-3005
(512) 767-0055
(512) 597-8824
Mailing address
PO BOX 92944, AUSTIN, TX 78709-2944
(512) 767-0055
(512) 597-8824
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/12/2012
Last updated
11/12/2014
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