Provider Demographics
NPI:1922207018
Name:CORNERSTONE DAY TREATMENT PROGRAM
Entity Type:Organization
Organization Name:CORNERSTONE DAY TREATMENT PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:THATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:707-485-1301
Mailing Address - Street 1:9551 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95470-6409
Mailing Address - Country:US
Mailing Address - Phone:707-485-1301
Mailing Address - Fax:707-485-7944
Practice Address - Street 1:9551 N STATE ST
Practice Address - Street 2:
Practice Address - City:REDWOOD VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95470-6409
Practice Address - Country:US
Practice Address - Phone:707-485-1301
Practice Address - Fax:707-485-7944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization