Provider Demographics
NPI:1811440910
Name:CORNERSTONE COMPANION SERVICES, LLC
Entity type:Organization
Organization Name:CORNERSTONE COMPANION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-343-1341
Mailing Address - Street 1:2445 LANE PARK RD
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-9648
Mailing Address - Country:US
Mailing Address - Phone:352-343-1341
Mailing Address - Fax:352-343-6115
Practice Address - Street 1:601 CASA BELLA
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-3640
Practice Address - Country:US
Practice Address - Phone:352-343-1341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health