Capital District Respite, Inc.

Primary specialty

Child Mental Illness Respite CareTaxonomy code 385HR2055X

Legal business name

CAPITAL DISTRICT RESPITE, INC.

Practice address

199 Milton Ave Ste 11
Ballston Spa, NY 12020-1454

Phone

(518) 527-6531

Fax

(518) 373-2901

NPI assigned

Feb 24, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Paula A. Tambasco

Title

Executive Director

Phone

(518) 527-6531

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1790177061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 111",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120200111",
            "telephone_number": "518-527-6531",
            "fax_number": "518-373-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 MILTON AVE STE 11",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120201454",
            "telephone_number": "518-527-6531",
            "fax_number": "518-373-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL DISTRICT RESPITE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "TAMBASCO",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "518-527-6531",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03327819",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Child Mental Illness Respite Care in Ballston Spa, NY
• Providers in Ballston Spa, NY by specialty
• Child Mental Illness Respite Care in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.