Provider Demographics
NPI:1093916710
Name:CORNERSTONE REHABILITATION LTD
Entity Type:Organization
Organization Name:CORNERSTONE REHABILITATION LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARROD
Authorized Official - Suffix:
Authorized Official - Credentials:MED-CCC-SLP
Authorized Official - Phone:419-501-2165
Mailing Address - Street 1:253 WEST SIXTH STREET
Mailing Address - Street 2:
Mailing Address - City:MINSTER
Mailing Address - State:OH
Mailing Address - Zip Code:45865
Mailing Address - Country:US
Mailing Address - Phone:419-501-2165
Mailing Address - Fax:419-501-2166
Practice Address - Street 1:253 WEST SIXTH STREET
Practice Address - Street 2:
Practice Address - City:MINSTER
Practice Address - State:OH
Practice Address - Zip Code:45865
Practice Address - Country:US
Practice Address - Phone:419-501-2165
Practice Address - Fax:419-501-2166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT10452225100000X
OHPT006863225100000X
OH33.013487225700000X
OH33.014100225700000X
OHOT006719225X00000X
OHOT001182225X00000X
OHOT003819225X00000X
OHSLP5126235Z00000X
OHSP4804235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000523169OtherBLUE CROSS BLUE SHIELD
OH000000523170OtherBLUE CROSS BLUE SHIELD
OH000000376025OtherBLUE CROSS BLUE SHIELD
OH232804807OtherREHAB PROVIDER NETWORK
OH2781431Medicaid
OH000000523169OtherBLUE CROSS BLUE SHIELD
OH=========00OtherWORKER'S COMPENSATION