Provider Demographics
NPI:1457384083
Name:OLANIKE OLUWOLE
Entity Type:Organization
Organization Name:OLANIKE OLUWOLE
Other - Org Name:CORNERSTONE HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLANIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-219-1200
Mailing Address - Street 1:982 N GARDEN RIDGE BLVD
Mailing Address - Street 2:STE. 220B
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2827
Mailing Address - Country:US
Mailing Address - Phone:972-219-1200
Mailing Address - Fax:972-434-0400
Practice Address - Street 1:982 N GARDEN RIDGE BLVD
Practice Address - Street 2:STE. 220B
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-2827
Practice Address - Country:US
Practice Address - Phone:972-219-1200
Practice Address - Fax:972-434-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010557251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679716Medicare Oscar/Certification