Provider Demographics
NPI:1144786823
Name:CAPSTONE-HOUSTON OPCO LLC
Entity Type:Organization
Organization Name:CAPSTONE-HOUSTON OPCO LLC
Other - Org Name:CAPSTONE HEALTHCARE ESTATES ON OREM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-712-6025
Mailing Address - Street 1:3730 W OREM DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045-4426
Mailing Address - Country:US
Mailing Address - Phone:832-405-6245
Mailing Address - Fax:713-534-1691
Practice Address - Street 1:3730 W OREM DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77045-4426
Practice Address - Country:US
Practice Address - Phone:832-405-6245
Practice Address - Fax:713-534-1691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility