Provider Demographics
NPI:1326280579
Name:CORNERSTONE COMMUNITY SUPPORT SERVICES, INC,
Entity Type:Organization
Organization Name:CORNERSTONE COMMUNITY SUPPORT SERVICES, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-235-2536
Mailing Address - Street 1:412 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-2726
Mailing Address - Country:US
Mailing Address - Phone:252-235-2536
Mailing Address - Fax:252-235-2816
Practice Address - Street 1:412 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2726
Practice Address - Country:US
Practice Address - Phone:252-235-2536
Practice Address - Fax:252-235-2816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health