Provider Demographics
NPI:1124140363
Name:CORNERSTONE REHABILITATION AND WELLNESS
Entity type:Organization
Organization Name:CORNERSTONE REHABILITATION AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-908-2812
Mailing Address - Street 1:1106 KINGSDALE CT
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2019
Mailing Address - Country:US
Mailing Address - Phone:301-908-2812
Mailing Address - Fax:
Practice Address - Street 1:1106 KINGSDALE CT
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:MD
Practice Address - Zip Code:20721-2019
Practice Address - Country:US
Practice Address - Phone:301-908-2812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health