Provider Demographics
NPI:1396069258
Name:CORNERSTONE ENTERPRISES & GENERAL CONTRACTING
Entity type:Organization
Organization Name:CORNERSTONE ENTERPRISES & GENERAL CONTRACTING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAI
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-492-0740
Mailing Address - Street 1:30043 LANIER DR
Mailing Address - Street 2:
Mailing Address - City:MEADOWVIEW
Mailing Address - State:VA
Mailing Address - Zip Code:24361-3445
Mailing Address - Country:US
Mailing Address - Phone:276-492-0740
Mailing Address - Fax:
Practice Address - Street 1:30043 LANIER DR
Practice Address - Street 2:
Practice Address - City:MEADOWVIEW
Practice Address - State:VA
Practice Address - Zip Code:24361-3445
Practice Address - Country:US
Practice Address - Phone:276-492-0740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2095310400000X
VA2305004843310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility