Provider Demographics
NPI:1275687352
Name:CAPSTONE SERVICES, LLC
Entity Type:Organization
Organization Name:CAPSTONE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:HAFDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-641-0042
Mailing Address - Street 1:1410 ENERGY PARK DR STE 10
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-5249
Mailing Address - Country:US
Mailing Address - Phone:651-641-0042
Mailing Address - Fax:651-645-2780
Practice Address - Street 1:1410 ENERGY PARK DR STE 10
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-5249
Practice Address - Country:US
Practice Address - Phone:651-641-0042
Practice Address - Fax:651-645-2780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10278262WS320900000X
MN10278242WS320900000X
MN10278253WS320900000X
MN10357212WS320900000X
MN10278272SILS320900000X
MN10278232WS320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities