Provider Demographics
NPI:1467228767
Name:MYCORNERSTONE HOME HEALTHCARE INC
Entity Type:Organization
Organization Name:MYCORNERSTONE HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AJIBOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLAWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-485-4705
Mailing Address - Street 1:7315 LONGSPUR HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-4704
Mailing Address - Country:US
Mailing Address - Phone:713-485-4705
Mailing Address - Fax:
Practice Address - Street 1:9894 BISSONNET ST STE 210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8246
Practice Address - Country:US
Practice Address - Phone:713-485-4705
Practice Address - Fax:713-730-3639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-28
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health