Provider Demographics
NPI:1902637705
Name:CORNERSTONE 20 SERVICES
Entity type:Organization
Organization Name:CORNERSTONE 20 SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:OFAANGA
Authorized Official - Middle Name:I
Authorized Official - Last Name:STATEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-589-3747
Mailing Address - Street 1:7275 SOUVERAIN LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-5657
Mailing Address - Country:US
Mailing Address - Phone:510-589-3747
Mailing Address - Fax:
Practice Address - Street 1:7275 SOUVERAIN LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-5657
Practice Address - Country:US
Practice Address - Phone:510-589-3747
Practice Address - Fax:866-598-4028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home