Provider Demographics
NPI:1205470143
Name:CAPOE LLC
Entity type:Organization
Organization Name:CAPOE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:POE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-436-4597
Mailing Address - Street 1:5609 FOX DEN TRL
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-1602
Mailing Address - Country:US
Mailing Address - Phone:404-436-4597
Mailing Address - Fax:
Practice Address - Street 1:5609 FOX DEN TRL
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-1602
Practice Address - Country:US
Practice Address - Phone:404-436-4597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health