Provider Demographics
NPI:1518656123
Name:CORNERSTONE COMMUNITY
Entity Type:Organization
Organization Name:CORNERSTONE COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLOREA
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:509-888-3311
Mailing Address - Street 1:12125 DETILLION RD
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:WA
Mailing Address - Zip Code:98826-9171
Mailing Address - Country:US
Mailing Address - Phone:509-888-3311
Mailing Address - Fax:509-548-6727
Practice Address - Street 1:12125 DETILLION RD
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:WA
Practice Address - Zip Code:98826-9171
Practice Address - Country:US
Practice Address - Phone:509-888-3311
Practice Address - Fax:509-548-6727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty