Healthcare Provider Details

I. General information

NPI: 1407291107
Provider Name (Legal Business Name): CORNERSTONE HEALTH CARE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 KINDERTON BLVD
ADVANCE NC
27006-7302
US

IV. Provider business mailing address

1701 WESTCHESTER DR SUITE 850
HIGH POINT NC
27262-7008
US

V. Phone/Fax

Practice location:
  • Phone: 336-802-2205
  • Fax: 336-802-2206
Mailing address:
  • Phone: 336-802-2400
  • Fax: 336-802-2534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: LINDA SUE RICHE
Title or Position: BUSINESS SERVICES DIRECTOR
Credential:
Phone: 336-802-2437