CAPITAL DISTRICT RESPITE, INC. (NPI# 1790177061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790177061 |
| Entity Type | Organization |
| Organization Name | CAPITAL DISTRICT RESPITE, INC. |
| Practice Address |
199 Milton Ave Ste 11 Ballston Spa NY 12020-1454 |
| Mailing Address |
Po Box 111 Ballston Spa NY 12020-0111 |
| Practice Telephone | 5185276531 |
| Practice Fax Number | 5183732901 |
| Mailing Telephone | 5185276531 |
| Mailing Fax Number | 5183732901 |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2015-02-24 |
| Authorized Official Name | MS. PAULA A. TAMBASCO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5185276531 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
Respite Care Facility |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03327819 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | CAPITAL DISTRICT RESPITE, INC. | P.o. Box 111, Ballston Spa, New York 12020 |
| Street Address |
199 MILTON AVE STE 11 |
| City | BALLSTON SPA |
| State | NY |
| Zip Code | 12020-1454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811529415 | Peter Joseph Valastro Jr. | Registered Nurse | 2452 Us Rt 9 Suite 206, Malta, NY 12020 | 2020-02-11 |
| 1083257224 | Martins Foods of South Burlington LLC | Durable Medical Equipment & Medical Supplies | 3 Via Rossi Way, Ballston Spa, NY 12020 | 2019-10-21 |
| 1528542255 | Mary Szacik | Social Worker | 2452 Us Rt. 9, Suite 206, Malta, NY 12020 | 2018-09-19 |
| 1669966867 | Adam Smatko | Social Worker | 2452 Us Route 9, Suite 206, Malta, NY 12020 | 2018-06-20 |
| 1538665104 | Tressa Frese | Counselor | 35 Bath Street, Ballston Spa, NY 12020 | 2018-04-03 |
| 1902312556 | Maltavista Optometry, Pllc | Optometrist | 2715 Rt 9, Suite 204, Malta, NY 12020 | 2017-12-19 |
| 1497207294 | Julie Lapham | Counselor | 100 Saratoga Village Blvd. Suite 26, Malta, NY 12020 | 2016-10-27 |
| 1932656527 | Matthew Kattell | Physical Therapist | 4102 Ellsworth Boulevard, Malta, NY 12020 | 2016-09-01 |
| 1295134740 | Nnenna Lindsay | Psychologist | 15 Trieble Avenue, Suite 5 Pmb 1013, Ballston Spa, NY 12020 | 2014-08-21 |
| 1023425956 | Jessica Duell | Registered Nurse | 603 Sweetman Road, Ballston Spa, NY 12020 | 2014-07-11 |
| Find all providers in zip 12020 | ||||
| Taxonomy Code | 385HR2055X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Illness, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023596699 | Henry O Edobor | Respite Care | 14927 Jamaica Ave Ste 5, Jamaica, NY 11435-4078 | 2018-08-05 |
| 1982182895 | Emmanuel Oszwa Odigie | Respite Care | 148-13 Hillside Ave, 2nd Fl Briarwood, Briarwood, NY 11435 | 2018-08-02 |
| 1982150694 | Mha of Rockland | Respite Care | 19 Albacon Rd, Nanuet, NY 10954-4415 | 2016-09-01 |
| 1609336841 | Supportive Services for Children, Inc | Respite Care | 14813 Hillside Ave, Jamaica, NY 11435-3330 | 2019-03-22 |
| 1487127775 | Sarah C Dume | Respite Care | 858 E 29th St, Brooklyn, NY 11210-2927 | 2019-01-09 |
| 1649742867 | Marie Sarah Alliance | Respite Care | 858 E 29th St, Brooklyn, NY 11210-2927 | 2018-12-28 |
| 1568909646 | Hudson River Housing, Inc. | Respite Care | 313 Mill St, Poughkeepsie, NY 12601-3115 | 2017-01-26 |
| City | BALLSTON SPA |
| Zip Code | 12020 |
Please comment or provide details below to improve the information on CAPITAL DISTRICT RESPITE, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.