MEDICARE: CAPSTONE BEHAVIORAL HEALTH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	2587	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154371748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPSTONE BEHAVIORAL HEALTH, INC.

Provider Business Mailing Address
First Line	:	1941 S 42ND ST
Second Line	:	STE. 328
City	:	OMAHA
State	:	NE
Zip	:	68105-2939
Country	:	US
Telephone Number	:	402-614-8444
Fax Number	:	402-614-8443

Provider Business Practice Location Address
First Line	:	1941 S 42ND ST
Second Line	:	STE. 328
City	:	OMAHA
State	:	NE
Zip	:	68105-2939
Country	:	US
Telephone Number	:	402-614-8444
Fax Number	:	402-614-8443

Authorized Official
Title or Position	:	SECRETARY
Name	:	STACY CLOYD
Credential	:
Telephone Number	:	904-605-4986

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	06/19/2023

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