Healthcare Provider Details

I. General information

NPI: 1356255053
Provider Name (Legal Business Name): CORNERSTONE CAREGIVING EAST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 NE WATULA AVE
OCALA FL
34470-5807
US

IV. Provider business mailing address

2612 WASHINGTON AVE STE 1
WACO TX
76710-7469
US

V. Phone/Fax

Practice location:
  • Phone: 352-644-9630
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: SIDNEY COZBY
Title or Position: DIR OF GOV PAYORS AND PROGRAMS
Credential:
Phone: 903-439-5177