Provider Demographics
NPI:1659146777
Name:CORNERSTONE RESIDENTIAL LIVING LLC
Entity Type:Organization
Organization Name:CORNERSTONE RESIDENTIAL LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:FALCONE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:559-731-8618
Mailing Address - Street 1:6715 W WREN AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-8344
Mailing Address - Country:US
Mailing Address - Phone:559-731-8618
Mailing Address - Fax:
Practice Address - Street 1:6715 W WREN AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-8344
Practice Address - Country:US
Practice Address - Phone:559-731-8618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty