Provider Demographics
NPI:1104521590
Name:CORNERSTONE LEARNING ACADEMY
Entity type:Organization
Organization Name:CORNERSTONE LEARNING ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHABAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-616-6901
Mailing Address - Street 1:10096 W FAIRVIEW AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-5004
Mailing Address - Country:US
Mailing Address - Phone:208-616-6901
Mailing Address - Fax:
Practice Address - Street 1:10096 W FAIRVIEW AVE STE 160
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-5004
Practice Address - Country:US
Practice Address - Phone:208-616-6901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-04
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)