Provider Demographics
NPI:1174318893
Name:CAPSTONE NGMC LLC
Entity type:Organization
Organization Name:CAPSTONE NGMC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:FRANCO
Authorized Official - Last Name:CORRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-589-6705
Mailing Address - Street 1:1224 S JACK TONE RD
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:CA
Mailing Address - Zip Code:95366-9352
Mailing Address - Country:US
Mailing Address - Phone:510-589-6705
Mailing Address - Fax:
Practice Address - Street 1:1644 CHENEY LANE
Practice Address - Street 2:1644 CHENEY LANE
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4331
Practice Address - Country:US
Practice Address - Phone:510-670-0239
Practice Address - Fax:510-784-0294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities