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General NPI Number Information
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NPI Number | 1275687352
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Entity Type | Organization
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Legal Business Name | CAPSTONE SERVICES, LLC
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1410 ENERGY PARK DR STE 10
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City | SAINT PAUL
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State | MN
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Zip | 55108-5249
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Country | US
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Telephone | 651-641-0042
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Fax | 651-645-2780
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Provider Business Mailing Address
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Address Line | 1410 ENERGY PARK DR STE 10
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City | SAINT PAUL
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State | MN
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Zip | 55108-5249
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Country | US
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Telephone | 651-641-0042
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Fax | 651-645-2780
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT PETER HAFDAHL
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Credential |
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Telephone | 651-641-0042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 10278242WS
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 10278253WS
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 10357212WS
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 10278272SILS
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 10278232WS
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License Number State | MN
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Taxonomy #6
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 10278262WS
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License Number State | MN
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