Healthcare Provider Details

I. General information

NPI: 1063837805
Provider Name (Legal Business Name): CORNERSTONE HELPING HANDS OF NORTH EAST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2014
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8170 SOUTH AVE SUITE 4
BOARDMAN OH
44512
US

IV. Provider business mailing address

2655 W NATIONAL RD
SPRINGFIELD OH
45504-3617
US

V. Phone/Fax

Practice location:
  • Phone: 330-782-8850
  • Fax: 330-782-8860
Mailing address:
  • Phone: 937-525-1531
  • Fax: 937-525-8317

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: JESSICA L UPDEGRAFF
Title or Position: PRESIDENT
Credential: RN
Phone: 614-357-4111