Healthcare Provider Details

I. General information

NPI: 1275081259
Provider Name (Legal Business Name): MADISON CAPSTONE OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2016
Last Update Date: 12/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 N 3RD ST
PHOENIX AZ
85012-3021
US

IV. Provider business mailing address

114 PACIFICA SUITE 230
IRVINE CA
92618-3302
US

V. Phone/Fax

Practice location:
  • Phone: 949-449-2500
  • Fax:
Mailing address:
  • Phone: 949-449-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: RACHEL SILVER
Title or Position: FINANCIAL RESOURCE
Credential:
Phone: 619-876-9252