Healthcare Provider Details

I. General information

NPI: 1326988619
Provider Name (Legal Business Name): CORNERSTONE RESIDENTIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6578 27TH ST S
FARGO ND
58104-7968
US

IV. Provider business mailing address

6578 27TH ST S
FARGO ND
58104-7968
US

V. Phone/Fax

Practice location:
  • Phone: 701-793-3264
  • Fax: 701-793-3264
Mailing address:
  • Phone: 701-793-3264
  • Fax: 701-793-3264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRISTIAN M BRAIMA
Title or Position: OWNER
Credential: QSP
Phone: 701-793-3264