Provider Demographics
NPI:1518401017
Name:CORNERSTONE PACE LLC
Entity type:Organization
Organization Name:CORNERSTONE PACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCARBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-742-6777
Mailing Address - Street 1:2445 LANE PARK RD
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-9648
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5601 S ORANGE AVE
Practice Address - Street 2:SUITE 5665
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4229
Practice Address - Country:US
Practice Address - Phone:888-728-6234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNERSTONE HOSPICE & PALLIATIVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization