Provider Demographics
NPI:1093061947
Name:CORNERSTONE, INC.
Entity Type:Organization
Organization Name:CORNERSTONE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:810-627-1293
Mailing Address - Street 1:4308 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROWN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48416-9711
Mailing Address - Country:US
Mailing Address - Phone:810-627-1293
Mailing Address - Fax:810-346-3125
Practice Address - Street 1:4308 MAIN ST
Practice Address - Street 2:
Practice Address - City:BROWN CITY
Practice Address - State:MI
Practice Address - Zip Code:48416-9711
Practice Address - Country:US
Practice Address - Phone:810-627-1293
Practice Address - Fax:810-346-3125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services