Provider Demographics
NPI:1508405069
Name:CAPSTONE HEALTH
Entity Type:Organization
Organization Name:CAPSTONE HEALTH
Other - Org Name:CAPSTONE DOUBLE SPRINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FOSTER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-686-5113
Mailing Address - Street 1:PO BOX 169
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:AL
Mailing Address - Zip Code:35580-0169
Mailing Address - Country:US
Mailing Address - Phone:205-686-5113
Mailing Address - Fax:205-265-2994
Practice Address - Street 1:110 LEGION RD STE B
Practice Address - Street 2:
Practice Address - City:DOUBLE SPRINGS
Practice Address - State:AL
Practice Address - Zip Code:35553-2365
Practice Address - Country:US
Practice Address - Phone:256-847-4858
Practice Address - Fax:205-489-2417
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPSTONE HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-02
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health