Provider Demographics
NPI:1811532112
Name:MINDS CORNERSTONE LLC
Entity type:Organization
Organization Name:MINDS CORNERSTONE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:APONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-930-3363
Mailing Address - Street 1:11 WILLIAMS STREET
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-1636
Mailing Address - Country:US
Mailing Address - Phone:860-593-4284
Mailing Address - Fax:
Practice Address - Street 1:11 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-1636
Practice Address - Country:US
Practice Address - Phone:860-593-4284
Practice Address - Fax:866-754-7662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-10
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health