Provider Demographics
NPI:1306133525
Name:CAPITOL CARE SOUTH
Entity type:Organization
Organization Name:CAPITOL CARE SOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:COVER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:205-956-2000
Mailing Address - Street 1:2619 COMMERCE BLVD
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-1211
Mailing Address - Country:US
Mailing Address - Phone:205-956-2000
Mailing Address - Fax:205-956-2001
Practice Address - Street 1:2619 COMMERCE BLVD
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-1211
Practice Address - Country:US
Practice Address - Phone:205-956-2000
Practice Address - Fax:205-956-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health