Provider Demographics
NPI:1710302088
Name:CORNERSTONE HELPING HANDS OF NORTH WEST
Entity Type:Organization
Organization Name:CORNERSTONE HELPING HANDS OF NORTH WEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:UPDEGRAFF
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:614-357-4111
Mailing Address - Street 1:2655 W NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-3617
Mailing Address - Country:US
Mailing Address - Phone:937-325-1531
Mailing Address - Fax:937-525-8317
Practice Address - Street 1:9072 AVERY CT
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43566-9604
Practice Address - Country:US
Practice Address - Phone:419-878-0451
Practice Address - Fax:419-878-0439
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNERSTONE MASONIC HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care