Organization
CAPITOL CITY HEALTH & REHABILITATION CENTER, L.P.
Active
Other names
Capitol City Health & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER J LICARI (VICE PRESIDENT)
(215) 441-7700
Entity
Organization
Contact information
Practice address
9052 GALEWOOD DR, AUSTIN, TX 78758-6495
(512) 836-9172
(512) 834-4376
Mailing address
200 DRYDEN ROAD, SUITE 2000, DRESHER, PA 19025
(215) 441-7700
(215) 441-4255
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
108164
TX
332BN1400X
Nursing Facility Supplies (DME)
115268
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
115268
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005140
—
TX
05
—
4534930001
—
TX
Enumeration date
10/12/2005
Last updated
10/25/2007
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