Healthcare Provider Details

I. General information

NPI: 1841244092
Provider Name (Legal Business Name): CORNERSTONE HOSPITAL OF SOUTHWEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 10/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 CYPRESS ST
SULPHUR LA
70663-5053
US

IV. Provider business mailing address

2200 ROSS AVE SUITE 5400
DALLAS TX
75201-2708
US

V. Phone/Fax

Practice location:
  • Phone: 337-527-1102
  • Fax: 337-527-1114
Mailing address:
  • Phone: 469-621-6700
  • Fax: 469-621-6672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number568
License Number StateLA

VIII. Authorized Official

Name: MRS. LYNN HUDSON
Title or Position: CENTRAL BUSINESS OFFICE DIRECTOR
Credential:
Phone: 469-621-6716