Provider Demographics
NPI:1063970671
Name:CORNERSTONE CARE INC.
Entity type:Organization
Organization Name:CORNERSTONE CARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-943-3308
Mailing Address - Street 1:7 GLASSWORKS RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:15338-9507
Mailing Address - Country:US
Mailing Address - Phone:724-943-3308
Mailing Address - Fax:724-943-3310
Practice Address - Street 1:559 MILLER AVE
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-1746
Practice Address - Country:US
Practice Address - Phone:724-943-3308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNERSTONE CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-04
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1376512582Medicaid