Provider Demographics
NPI:1124287016
Name:CORNERS OF CARE LLC
Entity type:Organization
Organization Name:CORNERS OF CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:DELORES
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:706-394-4220
Mailing Address - Street 1:3050 WHISKEY RD
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-9084
Mailing Address - Country:US
Mailing Address - Phone:803-226-0236
Mailing Address - Fax:803-226-0335
Practice Address - Street 1:3050 WHISKEY RD
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-9084
Practice Address - Country:US
Practice Address - Phone:803-226-0236
Practice Address - Fax:803-226-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management