Provider Demographics
NPI:1134440159
Name:CORNERSTONE CARE, INC.
Entity type:Organization
Organization Name:CORNERSTONE CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MTJOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-943-3308
Mailing Address - Street 1:104 FRONT STREET
Mailing Address - Street 2:VAN #1
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:PA
Mailing Address - Zip Code:15349-0495
Mailing Address - Country:US
Mailing Address - Phone:888-454-5064
Mailing Address - Fax:724-324-9005
Practice Address - Street 1:104 FRONT STREET
Practice Address - Street 2:VAN # 1
Practice Address - City:MOUNT MORRIS
Practice Address - State:PA
Practice Address - Zip Code:15349-0495
Practice Address - Country:US
Practice Address - Phone:888-454-5064
Practice Address - Fax:724-324-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center