Provider Demographics
NPI:1760717300
Name:COMMUNITTY CORNERSTONE
Entity Type:Organization
Organization Name:COMMUNITTY CORNERSTONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINADORA
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRODAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-686-0173
Mailing Address - Street 1:E 34 CALLE PALOMA
Mailing Address - Street 2:124 PASEO PALMA REAL
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777
Mailing Address - Country:US
Mailing Address - Phone:787-734-6078
Mailing Address - Fax:
Practice Address - Street 1:# 24
Practice Address - Street 2:ASHFORD ESQUINA BALDOTIORY
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-686-0170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5552261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)