Provider Demographics
NPI:1194239335
Name:COMMUNITY CORNERSTONE
Entity type:Organization
Organization Name:COMMUNITY CORNERSTONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELISHA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-247-5973
Mailing Address - Street 1:4561 PANTHER PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-3189
Mailing Address - Country:US
Mailing Address - Phone:919-247-5973
Mailing Address - Fax:
Practice Address - Street 1:1534 US HIGHWAY 321 N # B
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29180-6144
Practice Address - Country:US
Practice Address - Phone:919-247-5973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty