Provider Demographics
NPI:1164511093
Name:ADAMS COUNTY COUNCIL ON DRUG & ALCOHOL ABUSE
Entity Type:Organization
Organization Name:ADAMS COUNTY COUNCIL ON DRUG & ALCOHOL ABUSE
Other - Org Name:CORNERSTONE COUNSELING AND EDUCATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING/OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SPONSELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-632-6555
Mailing Address - Street 1:300 FREDERICK ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-3709
Mailing Address - Country:US
Mailing Address - Phone:717-632-6555
Mailing Address - Fax:717-632-5434
Practice Address - Street 1:300 FREDERICK ST
Practice Address - Street 2:SUITE 3
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-3709
Practice Address - Country:US
Practice Address - Phone:717-632-6555
Practice Address - Fax:717-632-5434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA677035101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007311330009Medicaid