Provider Demographics
NPI:1174598908
Name:CAPSTONE BEHAVIORAL HEALTHCARE, INC
Entity type:Organization
Organization Name:CAPSTONE BEHAVIORAL HEALTHCARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENAE
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:NORTHCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:641-792-4012
Mailing Address - Street 1:1123 1ST AVE E.
Mailing Address - Street 2:#200
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3981
Mailing Address - Country:US
Mailing Address - Phone:641-792-4012
Mailing Address - Fax:641-791-0697
Practice Address - Street 1:1123 1ST AVE E
Practice Address - Street 2:#200
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3981
Practice Address - Country:US
Practice Address - Phone:641-792-4012
Practice Address - Fax:641-791-0697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
IA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0022376Medicaid
IA02237Medicare PIN