Provider Demographics
NPI:1164667531
Name:CORNERSTONE HOME HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:CORNERSTONE HOME HEALTH SERVICES INC.
Other - Org Name:CORNERSTONE HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLANIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-464-2296
Mailing Address - Street 1:2201 MIDWAY RD
Mailing Address - Street 2:STE 112B
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-5079
Mailing Address - Country:US
Mailing Address - Phone:469-464-2296
Mailing Address - Fax:469-464-2298
Practice Address - Street 1:2201 MIDWAY RD
Practice Address - Street 2:STE 112B
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-5079
Practice Address - Country:US
Practice Address - Phone:469-464-2296
Practice Address - Fax:469-464-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012256251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679716Medicare Oscar/Certification