Provider Demographics
NPI:1427247287
Name:CORNERSTONE COMMUNITY SUPPORT SERVICES, INC.
Entity type:Organization
Organization Name:CORNERSTONE COMMUNITY SUPPORT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-235-2536
Mailing Address - Street 1:6291 E. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BAILEY
Mailing Address - State:NC
Mailing Address - Zip Code:27807-8990
Mailing Address - Country:US
Mailing Address - Phone:252-235-2536
Mailing Address - Fax:252-235-2816
Practice Address - Street 1:6291 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:BAILEY
Practice Address - State:NC
Practice Address - Zip Code:27807-8990
Practice Address - Country:US
Practice Address - Phone:252-235-2536
Practice Address - Fax:252-235-2816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency