Provider Demographics
NPI: | 1215372917 |
---|---|
Name: | CORNERSTONE HEALTH CARE, PA |
Entity type: | Organization |
Organization Name: | CORNERSTONE HEALTH CARE, PA |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | BUSINESS SERVICES DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LINDA |
Authorized Official - Middle Name: | SUE |
Authorized Official - Last Name: | RICHE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 336-802-2347 |
Mailing Address - Street 1: | 1701 WESTCHESTER DR |
Mailing Address - Street 2: | SUITE 850 |
Mailing Address - City: | HIGH POINT |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27262-7008 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 336-802-2400 |
Mailing Address - Fax: | 336-802-2534 |
Practice Address - Street 1: | 306 WESTWOOD AVE |
Practice Address - Street 2: | SUITE 401 |
Practice Address - City: | HIGH POINT |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27262-4341 |
Practice Address - Country: | US |
Practice Address - Phone: | 336-802-2205 |
Practice Address - Fax: | 336-802-2206 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-05-08 |
Last Update Date: | 2013-05-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty |