Provider Demographics
NPI:1306983044
Name:CAPABILITY HEALTH & HUMAN SERVICES
Entity type:Organization
Organization Name:CAPABILITY HEALTH & HUMAN SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACK GUNDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-870-7050
Mailing Address - Street 1:7281 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1592
Mailing Address - Country:US
Mailing Address - Phone:702-870-7050
Mailing Address - Fax:702-870-7616
Practice Address - Street 1:7281 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1592
Practice Address - Country:US
Practice Address - Phone:702-870-7050
Practice Address - Fax:702-870-7616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100504220Medicaid
NV006102517Medicaid
NV1306983044Medicaid