Provider Demographics
NPI:1093360398
Name:CORNERSTONE BEHAVIORAL ANALYSIS
Entity Type:Organization
Organization Name:CORNERSTONE BEHAVIORAL ANALYSIS
Other - Org Name:CORNERSTONE BEHAVIORAL ANALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:786-212-5530
Mailing Address - Street 1:1535 N GOLDENEYE LN
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-1037
Mailing Address - Country:US
Mailing Address - Phone:786-212-5530
Mailing Address - Fax:
Practice Address - Street 1:1535 N GOLDENEYE LN
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-1037
Practice Address - Country:US
Practice Address - Phone:786-212-5530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-05
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty