Provider Demographics
NPI:1316631484
Name:CORNERSTONE AL, LLC
Entity type:Organization
Organization Name:CORNERSTONE AL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGNAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-550-4141
Mailing Address - Street 1:5554 E CAMPO BELLO DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5847
Mailing Address - Country:US
Mailing Address - Phone:602-550-4141
Mailing Address - Fax:
Practice Address - Street 1:5554 E CAMPO BELLO DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5847
Practice Address - Country:US
Practice Address - Phone:602-550-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility