Provider Demographics
NPI:1285089003
Name:CAPABILITIES, INC.
Entity type:Organization
Organization Name:CAPABILITIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AJ
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-734-2006
Mailing Address - Street 1:1149 SULLIVAN ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-1670
Mailing Address - Country:US
Mailing Address - Phone:607-734-2006
Mailing Address - Fax:607-734-1514
Practice Address - Street 1:1149 SULLIVAN ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-1670
Practice Address - Country:US
Practice Address - Phone:607-734-2006
Practice Address - Fax:607-734-1514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02890339Medicaid
NY02171346Medicaid