Provider Demographics
NPI:1851587802
Name:CORNERSTONE HOME HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:CORNERSTONE HOME HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:JUEN
Authorized Official - Last Name:CORDERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-596-9477
Mailing Address - Street 1:840 111TH AVE N
Mailing Address - Street 2:SUITE 13
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-1877
Mailing Address - Country:US
Mailing Address - Phone:239-596-9477
Mailing Address - Fax:
Practice Address - Street 1:840 111TH AVE N
Practice Address - Street 2:SUITE13
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-1877
Practice Address - Country:US
Practice Address - Phone:239-596-9477
Practice Address - Fax:239-596-3593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-23
Last Update Date:2007-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health