| NPI | 1578233003 |
|---|---|
| Other Name | CAPITAL DISTRICT DDSO |
| Entity Type | Organization |
| Authorized Contact | EARL RAYMOND JEFFERSON Director Of Central Operations 518-402-4333 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2021-09-16 |