Healthcare Provider Details

I. General information

NPI: 1114034303
Provider Name (Legal Business Name): CORNERSTONE HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5636 GLACIER HWY STE 100
JUNEAU AK
99801-9508
US

IV. Provider business mailing address

5636 GLACIER HWY STE 100
JUNEAU AK
99801-9508
US

V. Phone/Fax

Practice location:
  • Phone: 907-586-6838
  • Fax: 907-586-8114
Mailing address:
  • Phone: 907-586-6838
  • Fax: 907-586-8114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number239941
License Number StateAK

VIII. Authorized Official

Name: MRS. CORRINE RAGO
Title or Position: CEO
Credential: RN
Phone: 907-586-6838