Provider Demographics
NPI:1306992946
Name:CAPITAL HOME HEALTH, INC
Entity type:Organization
Organization Name:CAPITAL HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LIBAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-818-2708
Mailing Address - Street 1:5898 CLEVELAND AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6884
Mailing Address - Country:US
Mailing Address - Phone:614-818-2708
Mailing Address - Fax:
Practice Address - Street 1:5898 CLEVELAND AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6884
Practice Address - Country:US
Practice Address - Phone:614-818-2708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2705700Medicaid
OH368153Medicare UPIN